Abstract:
INTRODUCTION:Real-world data on current treatment practices for non-small-cell lung cancer (NSCLC) are needed to understand the place in therapy and potential economic impact of newer therapies. PATIENTS AND METHODS:This retrospective cohort study identified patients ≥ 65 years old in the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database with first-time diagnosis of stage IIIB/IV NSCLC from 2007-2011 who received second-line therapy after first-line platinum-based chemotherapy from 2007 through mid-2013. Second-line regimens, health care resource use, adverse events (AEs), and associated costs were analyzed descriptively. Overall survival was determined by Kaplan-Meier test. Costs were adjusted to 2013 US dollars. RESULTS:We identified 4033 patients with advanced NSCLC who received second-line therapy (47% of those who received first-line platinum-based chemotherapy). Mean (SD) age was 73 (5) years, 2246 (56%) were male; 1134 (28%) and 2899 (72%) had squamous and nonsquamous NSCLC, respectively. The 4 most common second-line regimens were pemetrexed (22%), docetaxel (12%), carboplatin/paclitaxel (11%), and gemcitabine (7%). Median overall survival from second-line therapy initiation was 7.3 months (95% confidence interval, 7.0-7.7). Dyspnea and anemia were the most common AEs of interest, affecting 29% and 26% of patients, respectively; atypical pneumonia was associated with the highest AE-related costs (mean, $5339). The mean total per-patient-per-month cost was $10,885; AE-related per-patient-per-month costs totaled $1036 (10%). Costs were highest for pemetrexed-treated patients. CONCLUSION:These real-world data illustrate the variety of second-line regimens, poor prognosis, and high cost of second-line chemotherapy for patients with advanced NSCLC treated before the approval of immunotherapies for these patients.
journal_name
Clin Lung Cancerjournal_title
Clinical lung cancerauthors
Arunachalam A,Li H,Bittoni MA,Camacho R,Cao X,Zhong Y,Lubiniecki GM,Carbone DPdoi
10.1016/j.cllc.2018.05.016subject
Has Abstractpub_date
2018-09-01 00:00:00pages
e783-e799issue
5eissn
1525-7304issn
1938-0690pii
S1525-7304(18)30136-0journal_volume
19pub_type
杂志文章abstract:BACKGROUND:Limited data is available on comorbidity assessment in patients with lung cancer. The present prospective study assessed the prevalence and association of the Charlson comorbidity index (CCI) and simplified comorbidity score (SCS) with clinical outcomes in patients with newly diagnosed lung cancer undergoing...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2015.10.002
更新日期:2016-05-01 00:00:00
abstract::The treatment landscape of small-cell lung cancer is rapidly evolving. Results of the first-line randomized trial comparing etoposide/carboplatin/placebo with etoposide/carboplatin/atezolizumab (IMpower-133) were recently published, showing a longer progression-free survival and overall survival for patients receiving...
journal_title:Clinical lung cancer
pub_type: 杂志文章,评审
doi:10.1016/j.cllc.2018.12.019
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abstract:BACKGROUND:Major guidelines do not recommend routine molecular profiling of lung squamous-cell carcinoma (LUSC) because the prevalence of actionable alterations is thought to be low. Increased utilization of next-generation sequencing (NGS), particularly with cell-free circulating tumor DNA, facilitates reevaluation of...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2018.08.020
更新日期:2019-01-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:The benefits of immune checkpoint inhibitors for first-line treatment in patients with lung adenocarcinoma harboring EGFR mutations are unclear. The effects of ICIs depend on the tumor microenvironment (TME). Differences in TME properties between mutant and wild-type EGFR have not been fully characterized. ...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2018.03.011
更新日期:2018-09-01 00:00:00
abstract:INTRODUCTION:We examined the effect of access to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) therapy on survival for Asian female (AF) EGFR mutation-enriched patients with advanced lung adenocarcinoma. MATERIALS AND METHODS:We used the Surveillance Epidemiology and End Results database to s...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2016.08.008
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Standard treatment for stage III non-small-cell lung cancer (NSCLC) is concurrent chemotherapy and radiation (chemo-RT). However, N3 stage IIIB disease portends a worse prognosis and the tolerability of chemo-RT in patients ≥70 years old is a concern. In this analysis, we evaluate the survival of patients wi...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2019.04.003
更新日期:2019-07-01 00:00:00
abstract:UNLABELLED:We retrospectively reviewed a total of 257 stage I to IIIa lung adenocarcinoma after resection, tested them for the epidermal growth factor receptor (EGFR) mutation, and analyzed the effect of perioperative treatment on survival. The results showed that in patients with an EGFR mutation, adjuvant EGFR-tyrosi...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2015.04.002
更新日期:2015-11-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2018.10.010
更新日期:2019-03-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2015.05.001
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2018.08.019
更新日期:2019-01-01 00:00:00
abstract::Activating mutations in the epidermal growth factor receptor (EGFR) gene are extremely rare in small-cell lung cancer (SCLC). Here, we present a case of an EGFR-mutant gefitinib-responsive non-small-cell lung cancer (NSCLC) of adenocarcinoma histology occurring in a never-smoker followed by subsequent diagnosis of met...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/CLC.2010.n.046
更新日期:2010-09-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/CLC.2007.n.003
更新日期:2007-01-01 00:00:00
abstract::Recent advances in cancer cell biology have led to the development of therapeutic agents that target pathways critical to the development and progression of disease. These so-called "targeted therapies" might offer patients a more tolerable alternative to traditional systemic chemotherapy that often achieves therapeut...
journal_title:Clinical lung cancer
pub_type: 杂志文章,评审
doi:10.3816/CLC.2006.n.037
更新日期:2006-09-01 00:00:00
abstract:INTRODUCTION:Frailty of surgical patients has been associated with worse outcomes. There is limited literature discussing frailty in patients with lung cancer treated with stereotactic body radiotherapy (SBRT). This study assesses the relationship between frailty and overall survival (OS), tumor control, and toxicity i...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2018.05.008
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Little is known about the difference between black and non-black patients with epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC), particularly regarding survival. We thus characterized the EGFR expression profile, clinical characteristics, and survival outcome in these patien...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2019.07.003
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Although radical segmentectomy is an accepted treatment option for small-sized lung cancer, the outcomes remain unclear. The present study aimed to elucidate recurrence patterns and to identify predictors of time to recurrence after intentional segmentectomy for early lung cancer. PATIENTS AND METHODS:Prosp...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2019.06.004
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:The optimal treatment strategy for locoregional recurrences developing after surgical resection in patients with non-small-cell lung cancer (NSCLC) is yet to be clearly established. PATIENTS AND METHODS:To investigate the efficacy and safety of radiotherapy (RT) and chemoradiotherapy (CRT), we reviewed the ...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2017.05.005
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Thoracic radiotherapy (TRT) with concurrent chemotherapy is standard for limited-stage small-cell lung cancer (LS-SCLC). However, the optimal dosing and fractionation remain unclear. The National Comprehensive Cancer Network guidelines have recommended either 45 Gy delivered twice daily (BID) or 60 to 70 Gy ...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2018.08.015
更新日期:2019-01-01 00:00:00
abstract:UNLABELLED:Non–small-cell lung carcinoma (NSCLC) (n = 65) were analyzed for promoter methylation of RASSF1A, CDH13, MGMT, ESR1, and DAPK genes in matching lung tumors, normal lung tissue, and blood samples. Aberrant methylation in CDH13 and MGMT was associated with clinicopathologic features of NSCLC. Hypermethylation ...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2011.11.003
更新日期:2012-07-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2016.11.012
更新日期:2017-07-01 00:00:00
abstract::Historically, malignant pleural mesothelioma patients with potentially resectable disease have been treated with surgery and radiation alone. With improvements in systemic and intrapleural treatment options, a movement toward multi-modality therapy has become more common. Systemic treatment options largely consist of ...
journal_title:Clinical lung cancer
pub_type: 杂志文章,评审
doi:10.3816/CLC.2009.n.005
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Computed tomography (CT)-guided lung biopsy is occasionally used for the lesions that were diagnosed as nonmalignant by transbronchial examination despite the fact that other clinical data suggested those as malignant. The purpose of this study is to evaluate the outcomes of CT fluoroscopy-guided cutting n...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/CLC.2011.n.007
更新日期:2011-01-01 00:00:00
abstract:UNLABELLED:Efficacy of first-line gefitinib for elderly epidermal growth factor receptor mutated patients with lung adenocarcinoma is uncertain. This study was aimed to investigate efficacy of gefitinib for such population. The primary endpoint was response rate (RR) and at least 12 cases were needed. Overall RR was 59...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2011.02.004
更新日期:2011-11-01 00:00:00
abstract::Traditionally, non-small-cell lung cancer (NSCLC) is not thought of as an immunosensitive malignancy. However, recent clinical results with GVAX, a granulocyte-macrophage colony-stimulating factor (GM-CSF) gene-transduced autologous tumor vaccine, may suggest otherwise. This review summarizes immune-induced activity c...
journal_title:Clinical lung cancer
pub_type: 杂志文章,评审
doi:10.3816/clc.2003.n.027
更新日期:2003-11-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.cllc.2015.05.009
更新日期:2015-11-01 00:00:00
abstract::Vascular endothelial growth factor (VEGF) is regulated by the hypoxia-inducible factor 1 (HIF1) pathway and is implicated in tumor progression and patient survival in many types of cancer. Insulin-like growth factor-binding protein 3 (IGFBP3) is also regulated by HIF1 but works in a completely different manner by modu...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/CLC.2004.n.011
更新日期:2004-03-01 00:00:00
abstract:INTRODUCTION/BACKGROUND:The aim of this study was to identify imaging-based predictors of progression in patients treated with SABR for stage I NSCLC. PATIENTS AND METHODS:Between March 2003 and December 2012, 117 patients with stage I NSCLC meeting our study criteria were treated with SABR at Stanford University. Med...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2013.12.011
更新日期:2014-07-01 00:00:00
abstract:PURPOSE:This phase II study evaluated the efficacy and toxicity of gemcitabine/paclitaxel given every 2 weeks in patients with advanced-stage non-small-cell lung cancer. Treatment with 1 previous chemotherapy regimen was allowed. Patients received gemcitabine 3000 mg/m(2) intravenously over 30 minutes and paclitaxel 15...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/CLC.2007.n.010
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Elderly patients are underrepresented in trials that establish definitive chemoradiotherapy as the standard of care for inoperable stage III non-small-cell lung carcinoma (NSCLC). This study analyzed radiotherapy treatment delivery and outcomes at our institution according to elderly (≥ 70 years old) or youn...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2013.05.001
更新日期:2013-11-01 00:00:00