Philip O. Buck, PhD, MPH, Director, US Health Outcomes and Medical Policy, GSK; Kimberly R. Saverno, PhD, RPh, Director of Pharmacoeconomics, Vector Oncology; Paul J.E. Miller; Bhakti Arondekar, Senior Director, Therapy Area Head, Specialty at GSK; Mark S. Walker, PhD, VP Scientific Affairs, Vector Oncology
Platin-based adjuvant chemotherapy has extended survival in clinical trials in patients with completely resected non-small cell lung cancer (NSCLC). There are few data on the use of adjuvant therapy in community-based clinical practice in the United States (US).
Materials and methods
This was a retrospective observational study using electronic medical record and billing data collected during routine care at US community oncology sites in the Vector Oncology Data Warehouse between January 2007 and January 2014. Patients aged ≥18 years with a primary diagnosis of NSCLC Stage IB-IIIA were eligible if they had undergone surgical resection. Treatment patterns, healthcare resource use and cost were recorded, stratified by stage at diagnosis.
The study included 609 patients (mean age 64.8 years, 52.9% male), of whom 215 had Stage IB disease, 130 Stage IIA/II, 110 Stage IIB and 154 Stage IIIA. Adjuvant systemic therapy after resection was given to 345/609 patients (56.7%), with lower use in patients with Stage IB disease (39.1%) than Stage II-IIIA disease (64.9–68.2%) (p<0.0001). The most common adjuvant regimen at all stages was the combination of carboplatin and paclitaxel. There were no statistically significant differences in office visits or incidence of hospitalization by disease stage. During adjuvant treatment, the total monthly median cost per patient was $17,389.75 (interquartile range (IQR): $8,815.61–23,360.85).
Adjuvant systemic therapy was used in some patients with Stage IB NSCLC and in majority of patients with Stage IIA-IIIA disease. There were few differences in regimen or healthcare resource use by disease stage.