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:Human immunodeficiency virus (HIV)-infected individuals are at increased risk for primary lung cancer (LC). We wished to compare the clinicopathologic features and treatment outcome of HIV-LC patients with HIV-indeterminate LC patients. We also sought to compare behavioral characteristics and immunologic fea...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/CLC.2010.n.051
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:The optimal treatment of locally advanced non-small-cell lung cancer (NSCLC) remains controversial. We hypothesized that using a trimodality approach in selected patients with stage IIIA/IIIB disease would be both feasible and efficacious with reasonable toxicity. PATIENTS/METHODS:We enrolled 13 patients wi...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2011.06.003
更新日期:2011-09-01 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:Cancer-associated macrophage-like cells (CAMLs) are a potential peripheral blood biomarker for disease progression. This study used data from a phase 2 clinical trial to evaluate prognostic utility of CAMLs for locally advanced non-small-cell lung cancer treated with definitive chemoradiotherapy (CRT) and at...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2020.06.016
更新日期:2020-06-20 00:00:00
abstract:INTRODUCTION:A recent review of phase I trials suggests that participation in these trials can be associated with clinical benefit and the rate of drug-related deaths is low. We conducted an analysis of the Cancer Therapy Evaluation Program (CTEP)-sponsored phase I trials to assess the outcomes of lung cancer patients ...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2011.03.022
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:While lepidic-predominant lung adenocarcinomas are known to have better outcomes than similarly sized solid tumors, the impact of smaller noninvasive foci within predominantly solid tumors is less clearly characterized. We tested the hypothesis that lung adenocarcinomas with even a small ground-glass opacity...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2017.06.020
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Obtaining a tissue diagnosis has traditionally been standard practice before initiating therapy for early-stage non-small-cell lung cancer (NSCLC). In several recent studies from Europe and Asia, a substantial proportion of patients have received stereotactic body radiation therapy (SBRT) based only on the i...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2014.04.001
更新日期:2014-07-01 00:00:00
abstract:INTRODUCTION:Small-cell lung cancer is an aggressive disease for which the mainstay of treatment is chemotherapy. Despite good initial responses most patients will relapse. Some will receive second-line therapy with clinical benefit, but for third-line chemotherapy there is little evidence to guide treatment decisions ...
journal_title:Clinical lung cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.cllc.2013.11.003
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Serum tumor markers are considered a negative prognostic factor in early-stages NSCLC but its role in advanced disease is controversial. The aim of this study is to analyze the prognostic value of tumor markers in advanced NSCLC. PATIENTS AND METHODS:Two hundred and seventy seven patients diagnosed in our i...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2011.03.019
更新日期:2011-05-01 00:00:00
abstract:INTRODUCTION:We examined mutational testing of the epidermal growth factor gene (EGFR) and erlotinib treatment among veterans diagnosed with non-small-cell lung cancer in the United States Department of Veterans Affairs (VA). Our objectives were to identify the prevalence of clinically actionable EGFR mutations, to det...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2016.11.018
更新日期:2017-07-01 00:00:00
abstract:INTRODUCTION:Currently, the role of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors as adjuvant therapy for early-stage non-small-cell lung cancer after complete surgical tumor resection remains under investigation. We present the rationale and study design for the ADAURA (ClinicalTrials.gov identifi...
journal_title:Clinical lung cancer
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.cllc.2018.04.004
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Azacitidine as an effective epigenetic therapeutic agent has not been used as an aerosol form to treat lung cancer patients. We aerosolized clinical grade azacitidine (Aza), optimized the formulation, and studied its pharmacokinetics and toxicity in mice. METHODS:Extrusion-precipitation method and DNA methy...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2015.09.005
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Hormesis is a favorable biological response to low toxin exposure. In the case of radiation, large doses are carcinogenic, but low doses might be protective. In the current study, we analyzed lung cancer incidence in high-impact radiation states where nuclear testing occurred and compared it with lung cancer...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2014.09.010
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are rapidly being developed for treatment of non-small-cell lung cancer (NSCLC) in patients harboring EGFR T790M mutations. This first-in-human phase 1 study evaluated the maximum tolerated dose, recommended phase 2 do...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2020.07.001
更新日期:2020-11-01 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: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::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::The International Lung Cancer Congress (ILCC), now in its ninth year, is a key forum for representatives of cooperative groups in North America, Europe, and Japan to discuss ongoing and planned clinical trials in lung cancer. Many of the significant strides in lung cancer treatment often originate from investigations ...
journal_title:Clinical lung cancer
pub_type:
doi:10.3816/CLC.2009.n.044
更新日期:2009-09-01 00:00:00
abstract::After decades of platinum-based chemotherapy for advanced small-cell lung cancer, there has finally been a therapeutic advance. The combination of a platinum chemotherapy, etoposide, and an immune checkpoint inhibitor has yielded overall survival benefits in two successive phase 3 trials. Unfortunately, these trials o...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2020.04.006
更新日期:2020-11-01 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::Multiple studies have confirmed the value of radiation therapy in limited-stage small-cell lung cancer. The appropriate dose of radiation and the optimal fractionation scheme, however, remain controversial. This article will examine the history of radiation therapy in the management of small-cell lung cancer. It will ...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/clc.2003.n.013
更新日期:2003-05-01 00:00:00
abstract:PURPOSE:We conducted a phase I trial of the topoisomerase I inhibitor topotecan for the purpose of determining the maximum tolerated dose (MTD) and the dose-limiting toxicities (DLTs) of topotecan when administered weekly to patients with advanced non-small-cell lung cancer. PATIENTS AND METHODS:Twelve patients with s...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/CLC.2010.n.035
更新日期:2010-07-01 00:00:00
abstract:INTRODUCTION:Patients with stage I small cell lung carcinoma (SCLC) are candidates for surgery; however, not much is known regarding the utilization of surgical resection in the management of stage I SCLC and the factors that determine the patient's ability to receive surgery. METHODS:The Surveillance, Epidemiology an...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2017.03.003
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study is to externally validate the 8th Edition of the Tumor, Node, and Metastasis staging system and its updated T descriptors in patients with non-small cell lung cancer with N3 disease. METHODS:Data were extracted from the Surveillance, Epidemiology, and End Results database. Chi-squ...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2017.05.009
更新日期:2017-11-01 00:00:00
abstract::Metastatic non-small-cell lung cancer is generally not considered to be curable, and the overall 5-year survival rate is less than 1%. Despite this poor prognosis, palliative chemotherapy can increase time and quality of life in the advanced-disease setting. New chemotherapy treatments and targeted therapies are avail...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2011.06.007
更新日期:2011-11-01 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
abstract:BACKGROUND:The immune checkpoint proteins programmed death-1/ligand (PD-1/PD-L1) play a critical role in immune escape of tumor cells. In models of epidermal growth factor receptor (EGFR)-driven non-small-cell lung cancer (NSCLC), EGFR signal upregulates PD-1/PD-L1. However, data on the clinical significance of PD1/PD-...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2015.02.002
更新日期:2015-09-01 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
abstract:INTRODUCTION:For lung cancer screening, the available data are often derived from patients enrolled prospectively in clinical trials. We, therefore, investigated lung cancer screening patterns among individuals eligible for, but not enrolled in, a screening trial. PATIENTS AND METHODS:From February 2017 through Februa...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2020.02.010
更新日期:2020-07-01 00:00:00
abstract::The identification of tumor biomarkers provides information on the prognosis and guides the implementation of appropriate treatment in patients with many different cancer types. In non-small cell lung cancer (NSCLC), targeted treatment plans based on biomarker identification have already been used in the clinic. Howev...
journal_title:Clinical lung cancer
pub_type: 杂志文章,评审
doi:10.1016/j.cllc.2014.06.005
更新日期:2014-11-01 00:00:00