Real-World Treatment Patterns, Overall Survival, and Occurrence and Costs of Adverse Events Associated With Second-Line Therapies for Medicare Patients With Advanced Non-Small-Cell Lung Cancer.


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.


Clin Lung Cancer


Clinical lung cancer


Arunachalam A,Li H,Bittoni MA,Camacho R,Cao X,Zhong Y,Lubiniecki GM,Carbone DP




Has Abstract


2018-09-01 00:00:00














  • Management of Central Nervous System Metastases in Patients With Advanced Anaplastic Lymphoma Kinase-Rearranged Non-Small-Cell Lung Cancer During Crizotinib Treatment.

    abstract:BACKGROUND:Central nervous system (CNS) progression is a common manifestation of acquired resistance to crizotinib in anaplastic lymphoma kinase (ALK)-rearranged non-small-cell lung cancer (NSCLC). However, an optimal tailored treatment approach has not been established in patients with CNS failure during crizotinib tr...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Zhao Y,Zhang B,Wang S,Qiao R,Xu J,Zhang L,Zhang Y,Han B

    更新日期:2019-11-01 00:00:00

  • Pathological examination and the reporting of lung cancer specimens.

    abstract::The Lung Cancer Disease Site Group (DSG) of the Cancer Care Ontario Practice Guidelines Initiative first met in January of 1994. Included in the membership were three pathologists who, with the other members of the DSG, felt that a useful contribution to the work of the group would be a recommendation on standardized ...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Chamberlain DW,Wenckebach GF,Alexander F,Fraser RS,Kolin A,Newman T

    更新日期:2000-05-01 00:00:00

  • Phase I and pharmacologic study of weekly bolus topotecan for advanced non-small-cell lung cancer.

    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


    authors: Masuda N,Matsui K,Negoro S,Takeda K,Kudoh S,Nakagawa K,Mukaiyama A,Arase H,Yoshida P,Ijima T,Takada M,Fukuoka M

    更新日期:2010-07-01 00:00:00

  • Nine-year Experience: Prophylactic Cranial Irradiation in Extensive Disease Small-cell Lung Cancer.

    abstract:BACKGROUND:In 2007, the European Organization for Research and Treatment of Cancer (EORTC) study ( identifier, NCT00016211) demonstrated a beneficial effect on overall survival (OS) with the use of prophylactic cranial irradiation (PCI) for extensive disease (ED) small-cell lung cancer (SCLC). Neverth...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Bernhardt D,Adeberg S,Bozorgmehr F,Opfermann N,Hoerner-Rieber J,Repka MC,Kappes J,Thomas M,Bischoff H,Herth F,Heußel CP,Debus J,Steins M,Rieken S

    更新日期:2017-07-01 00:00:00

  • Presence of Even a Small Ground-Glass Component in Lung Adenocarcinoma Predicts Better Survival.

    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


    authors: Berry MF,Gao R,Kunder CA,Backhus L,Khuong A,Kadoch M,Leung A,Shrager J

    更新日期:2018-01-01 00:00:00

  • Intercalated Chemotherapy and Epidermal Growth Factor Receptor Inhibitors for Patients With Advanced Non-Small-cell Lung Cancer: A Systematic Review and Meta-analysis.

    abstract::Randomized clinical trials (RCTs) of concurrent epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) plus chemotherapy for unselected patients with advanced non-small-cell lung cancer (NSCLC) produced negative results. Intercalated administration could avoid the reduction of chemotherapy activity du...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,meta分析,评审


    authors: La Salvia A,Rossi A,Galetta D,Gobbini E,De Luca E,Novello S,Di Maio M

    更新日期:2017-01-01 00:00:00

  • The Effect of Primary Care Physician Knowledge of Lung Cancer Screening Guidelines on Perceptions and Utilization of Low-Dose Computed Tomography.

    abstract:INTRODUCTION:Lung cancer screening (LCS) with low-dose computed tomography (LDCT) is recommended by the U.S. Preventive Services Task Force (USPSTF) in high-risk patients, but a minority of eligible people are screened. It is not clear whether knowledge of USPSTF recommendations among primary care physicians (PCP) affe...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Raz DJ,Wu GX,Consunji M,Nelson RA,Kim H,Sun CL,Sun V,Kim JY

    更新日期:2018-01-01 00:00:00

  • Lung cancer hormesis in high impact states where nuclear testing occurred.

    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


    authors: Lehrer S,Rosenzweig KE

    更新日期:2015-03-01 00:00:00

  • ERCC1, MLH1, MSH2, MSH6, and βIII-tubulin: resistance proteins associated with response and outcome to platinum-based chemotherapy in malignant pleural mesothelioma.

    abstract:INTRODUCTION:Platinum-based chemotherapy is besides the standard antifolate therapy with pemetrexed, the cornerstone for treatment of patients with malignant pleural mesothelioma (MPM), and its efficacy depends on several DNA repair enzymes. Therefore, these enzymes could be biomarkers for "tailoring" chemotherapy. Thi...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Ting S,Mairinger FD,Hager T,Welter S,Eberhardt WE,Wohlschlaeger J,Schmid KW,Christoph DC

    更新日期:2013-09-01 00:00:00

  • Maintenance or Consolidation Therapy for Non--Small-Cell Lung Cancer: A Meta-Analysis Involving 5841 Subjects.

    abstract:INTRODUCTION:Maintenance therapy is a new treatment paradigm for advanced non-small-cell lung cancer (NSCLC). We conducted a meta-analysis to evaluate its clinical efficacy in NSCLC and compared the efficacy of chemotherapy, epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), and other treatment ap...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,meta分析


    authors: Zhang C,Huang C,Wang J,Wang X,Li K

    更新日期:2015-09-01 00:00:00

  • Treatment of patients excluded from Eastern Cooperative Oncology Group 4599 and AVAiL studies: focus on brain metastasis and squamous histology.

    abstract::Bevacizumab is the first molecularly targeted agent associated with improved outcomes in combination with chemotherapy in previously untreated patients with non-small-cell lung cancer (NSCLC). The addition of bevacizumab, a monoclonal antibody against vascular endothelial growth factor (VEGF), to carboplatin and pacli...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,评审


    authors: Morgensztern D,Govindan R

    更新日期:2008-03-01 00:00:00

  • Gefitinib as first-line treatment in elderly epidermal growth factor receptor-mutated patients with advanced lung adenocarcinoma: results of a Nagano Lung Cancer Research Group study.

    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


    authors: Asami K,Koizumi T,Hirai K,Ameshima S,Tsukadaira A,Morozumi N,Morikawa A,Atagi S,Kawahara M

    更新日期:2011-11-01 00:00:00

  • Correlations Between the Immune-related Adverse Events Spectrum and Efficacy of Anti-PD1 Immunotherapy in NSCLC Patients.

    abstract:BACKGROUND:Immune-related adverse events (irAEs) developed during immunotherapy with anti-PD-1 agents, could be a predictive surrogate marker of clinical benefit in patients with advanced non-small-cell lung cancer (NSCLC). METHODS:Patients with NSCLC, treated with anti-PD-1 agents, were retrospectively evaluated. Uni...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,多中心研究


    authors: Cortellini A,Chiari R,Ricciuti B,Metro G,Perrone F,Tiseo M,Bersanelli M,Bordi P,Santini D,Giusti R,Grassadonia A,Di Marino P,Tinari N,De Tursi M,Zoratto F,Veltri E,Malorgio F,Garufi C,Russano M,Anesi C,Zeppola T,

    更新日期:2019-07-01 00:00:00

  • Prognostic role of ERCC1 in advanced non-small-cell lung cancer: a systematic review and meta-analysis.

    abstract:UNLABELLED:Small observational studies have demonstrated an association between high ERCC1 expression level and poor prognosis in advanced NSCLC treated with platinum-based chemotherapy. This meta-analysis presents pooled estimates of association from 11 studies. High ERCC1 patients had lower response rates and higher ...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,评审


    authors: Roth JA,Carlson JJ

    更新日期:2011-11-01 00:00:00

  • Effect of Thoracic Radiotherapy Timing and Fractionation on Survival in Nonmetastatic Small Cell Lung Carcinoma.

    abstract:BACKGROUND:The optimal timing of thoracic radiation therapy (RT) in relation to chemotherapy is unknown in the treatment of nonmetastatic small cell lung cancer (SCLC). We analyzed the National Cancer Data Base (NCDB) to assess the effect on overall survival (OS) of RT timing with chemotherapy for patients with SCLC. ...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Wong AT,Rineer J,Schwartz D,Becker D,Safdieh J,Osborn V,Schreiber D

    更新日期:2017-03-01 00:00:00

  • EGFR Testing in Advanced Non-Small-Cell Lung Cancer, A Mini-Review.

    abstract::Expert consensus guidelines have defined minimum requirements for routine testing and identification of classical epidermal growth factor (EGFR) mutations (ie, exon 19 deletions and exon 21 L858R substitution) and anaplastic lymphoma kinase (ALK) rearrangements in advanced non-small-cell lung cancers of adenocarcinoma...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,评审


    authors: Sheikine Y,Rangachari D,McDonald DC,Huberman MS,Folch ES,VanderLaan PA,Costa DB

    更新日期:2016-11-01 00:00:00

  • Concurrent chemoradiotherapy for patients with postoperative recurrence of surgically resected non-small-cell lung cancer.

    abstract:BACKGROUND:A few reports have evaluated the outcomes of concurrent chemoradiotherapy (CRT) for patients with postoperative recurrence of non-small cell lung cancer (NSCLC). PATIENTS AND METHODS:From 2000 through 2011, 1237 consecutive patients with NSCLC underwent pulmonary resection at our institution. Of those, 280 ...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Takenaka T,Takenoyama M,Toyozawa R,Inamasu E,Yoshida T,Toyokawa G,Shiraishi Y,Hirai F,Yamaguchi M,Seto T,Ichinose Y

    更新日期:2015-01-01 00:00:00

  • Clinical significance of the serum crosslinked N-telopeptide of type I collagen as a prognostic marker for non-small-cell lung cancer.

    abstract:INTRODUCTION:Lung cancer is the leading cause of cancer-related death. Many patients with lung cancer are in its advanced stages at the time of diagnosis. The 5-year survival rate for lung cancer is 10% to 20%, and the prognosis for patients with lung cancer is still poor. The crosslinked N-terminal telopeptide of type...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Tamiya M,Kobayashi M,Morimura O,Yasue T,Nakasuji T,Satomu M,Kohei O,Takayuki S,Morishita N,Suzuki H,Sasada S,Okamoto N,Hirashima T,Kawase I

    更新日期:2013-01-01 00:00:00

  • Addressing the current challenges of non-small-cell lung cancer clinical trial accrual.

    abstract::Conducting research in patients with non-small-cell lung cancer (NSCLC) is challenging, primarily because of low patient accrual rates resulting from patient-, physician-, protocol-, and healthcare system-related barriers. The Coalition of Cancer Cooperative Groups convened a 1-day program entitled Addressing the Curr...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,评审


    authors: Curran WJ Jr,Schiller JH,Wolkin AC,Comis RL,Scientific Leadership Council in Lung Cancer of the Coalition of Cancer Cooperative Groups.

    更新日期:2008-07-01 00:00:00

  • Combined-modality therapy for inoperable non-small-cell lung cancer using gemcitabine.

    abstract::Combined-modality therapy with chemotherapy and radiation appears to be the most efficacious therapeutic modality for patients with locally advanced non-small-cell lung cancer. Most of the trials exploring this approach have utilized older agents such as cisplatin, vinblastine, and etoposide. Recent data suggest that ...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Curran WJ Jr

    更新日期:2002-03-01 00:00:00

  • Real-World Clinical Impact of Immune Checkpoint Inhibitors in Patients With Advanced/Metastatic Non-Small Cell Lung Cancer After Platinum Chemotherapy.

    abstract:BACKGROUND:The real-world effect of anti-programmed death ligand 1 (PD-L1) therapies is unclear. We compared US patients who received second-line therapy for non-small-cell lung cancer (NSCLC) before and shortly after US Food and Drug Administration (FDA) approval of PD-L1 inhibitors. PATIENTS AND METHODS:Patients in ...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Schwartzberg L,Korytowsky B,Penrod JR,Zhang Y,Le TK,Batenchuk C,Krug L

    更新日期:2019-07-01 00:00:00

  • Weekly paclitaxel in elderly patients (aged > or = 70 years) with advanced non-small-cell lung cancer: an alternative choice? Results of a phase II study.

    abstract:PURPOSE:Paclitaxel and platinum-based chemotherapy is considered to be a standard approach for locally advanced and metastatic non-small-cell lung cancer (NSCLC). In recent years, weekly paclitaxel has been widely used for its safety profile, especially in breast and ovarian cancer. Otherwise, only a few studies are av...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Rossi D,Dennetta D,Ugolini M,Alessandroni P,Catalano V,Fedeli SL,Giordani P,Casadei V,Baldelli AM,Graziano F,Catalano G

    更新日期:2008-09-01 00:00:00

  • Genomic and proteomic analyses of vascular endothelial growth factor and insulin-like growth factor-binding protein 3 in lung adenocarcinomas.

    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


    authors: Gharib TG,Chen G,Huang CC,Misek DE,Iannettoni MD,Hanash SM,Orringer MB,Beer DG

    更新日期:2004-03-01 00:00:00

  • Association Between Environmental Tobacco Smoke Exposure and the Occurrence of EGFR Mutations and ALK Rearrangements in Never-smokers With Non-Small-cell Lung Cancer: Analyses From a Prospective Multinational ETS Registry.

    abstract:BACKGROUND:Molecular studies have demonstrated actionable driver oncogene alterations are more frequent in never-smokers with non-small-cell lung cancer (NSCLC). The etiology of these driver oncogenes in patients with NSCLC remains unknown, and environmental tobacco smoke (ETS) is a potential cause in these cases. MAT...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Soo RA,Kubo A,Ando M,Kawaguchi T,Ahn MJ,Ou SI

    更新日期:2017-09-01 00:00:00

  • Adjuvant therapy in non-small cell lung cancer: future treatment prospects and paradigms.

    abstract::There is a high risk of relapse after curative-intent resection for even early-stage non-small cell lung cancer (NSCLC), and thus adjuvant chemotherapy has been explored with the goal of eliminating occult metastases and consequently reducing the risk of recurrence. Although adjuvant chemotherapy confers a survival ad...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,评审


    authors: Carbone DP,Felip E

    更新日期:2011-09-01 00:00:00

  • Thoracic Oncology Multidisciplinary Clinic Reduces Unnecessary Health Care Expenditure Used in the Workup of Patients With Non-small-cell Lung Cancer.

    abstract:BACKGROUND:National costs of lung cancer care exceed $12 billion. We investigate the resource-savings benefit of a single-day thoracic oncology multidisciplinary clinic (MDC) in the diagnostic period prior to non-small-cell lung cancer (NSCLC) treatment. MATERIALS AND METHODS:From July 2007 to January 2015, patients w...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Voong KR,Liang OS,Dugan P,Torto D,Padula WV,Senter JP,Lang M,Hooker CM,Feliciano J,Broderick S,Yarmus L,Khanna K,Narang A,Hales RK

    更新日期:2019-07-01 00:00:00

  • Rationale and Design of PEMVITASTART-An Open-label Randomized Trial Comparing Simultaneous Versus Standard Initiation of Vitamin B12 and Folate Supplementation in Nonsquamous, Non-Small-cell Lung Cancer Patients Undergoing First-line Pemetrexed-based Chem

    abstract::Pemetrexed is the preferred chemotherapeutic drug for nonsquamous, non-small-cell lung cancer patients whenever the predictive molecular biomarkers for targeted therapy have either not been assessed or are absent. As per manufacturers' instructions, supplementation with folic acid (FA; folate) at a dose of 350 to 1000...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,随机对照试验


    authors: Baldi M,Behera D,Kaur J,Kapoor R,Singh N

    更新日期:2017-07-01 00:00:00

  • Small-cell carcinoma with an epidermal growth factor receptor mutation in a never-smoker with gefitinib-responsive adenocarcinoma of the lung.

    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


    authors: Alam N,Gustafson KS,Ladanyi M,Zakowski MF,Kapoor A,Truskinovsky AM,Dudek AZ

    更新日期:2010-09-01 00:00:00

  • Total videothoracoscopic lobectomy versus open thoracotomy for early-stage non small-cell lung cancer.

    abstract::Lobectomy remains the standard procedure for early-stage non small-cell lung cancer (NSCLC). Advances in minimally invasive surgery allow lobectomy to be performed by videothoracoscopy (VATSLOBE). The objective of this study was to compare open thoracotomy (OPENLOBE) to VATSLOBE in the treatment of early-stage NSCLC. ...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Luketich JD,Meehan MA,Landreneau RJ,Christie NA,Close JM,Ferson PF,Keenan RJ,Belani CP

    更新日期:2000-08-01 00:00:00

  • Phase II study of sequential treatment of advanced non-small-cell lung cancer: three cycles of high-dose epirubicin plus cisplatin followed by weekly vinorelbine.

    abstract::Previous phase I, II, and III studies on high-dose epirubicin (HDEPI), alone or in combination with cisplatin (CP), indicate an interesting activity of this drug in the treatment of non-small-cell lung cancer (NSCLC). However, the toxicological profile of HDEPI limits its prolonged use. In our experience, vinorelbine ...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Guaraldi M,Marino A,Pannuti F,Farabegoli G,Martoni A

    更新日期:2001-08-01 00:00:00