METHODS: This retrospective study used 2010 to 2019 U.S. Medicare claims, to identify elderly (≥ 66 years) patients with newly-diagnosed MCL who received third-line (3L) treatment and had evidence of cBTKi use in a prior line of therapy. Outcomes were assessed ≥ 12-months post 3L-treatment initiation and included treatment patterns, all-cause and MCL-related HRU and costs, and overall survival.
RESULTS: The final sample contained 230 elderly patients with R/R MCL receiving 3L treatment who had cBTKi use in a prior line of therapy (mean age 75.0, 21.7% age > 80 years; 67.4% male; 93.9% White). Common 3L treatments included chemotherapy (26.1%), lenalidomide (18.7%), and bortezomib (18.3%); 1-quarter (25.7%) of patients received a cBTKi (17.8% ibrutinib; 7.8% acalabrutinib). Overall survival was poor from 3L treatment initiation (median OS = 9.4 months; 1-years survival rate = 43.7%). Patients exhibited high rates of HRU (73.6% experienced hospitalization) and substantial costs ($145,726) in the 12-months after 3L initiation.
CONCLUSIONS: A large unmet need exists in this patient subpopulation, highlighting the importance of ongoing development of novel therapeutics.
方法:这项回顾性研究使用了2010年至2019年的美国医疗保险索赔,确定接受三线(3L)治疗且有证据表明在之前的治疗中使用cBTKi的老年(≥66岁)新诊断MCL患者.结果在3L治疗开始后≥12个月进行评估,并包括治疗模式,所有原因和MCL相关的HRU和成本,和总体生存率。
结果:最终样本包含230名接受3L治疗的R/RMCL老年患者,他们在先前的治疗路线中使用了cBTKi(平均年龄75.0,21.7%年龄>80岁;67.4%男性;93.9%白人)。常见的3L治疗包括化疗(26.1%),来那度胺(18.7%),和硼替佐米(18.3%);1/4(25.7%)的患者接受cBTKi(17.8%伊布替尼;7.8%阿卡拉布替尼).从3L治疗开始,总生存率较差(中位OS=9.4个月;1年生存率=43.7%)。在3L开始后的12个月中,患者表现出很高的HRU率(73.6%的住院经历)和可观的费用($145,726)。
结论:该患者亚群存在大量未满足的需求,强调正在开发的新型疗法的重要性。