■2017年2月在日本推出了用于晚期非小细胞肺癌(NSCLC)的一线免疫检查点抑制剂(ICI)单一疗法。自那时以来,关于日本非小细胞肺癌医疗保健资源使用的信息有限,住院负担很高的地方。
我们评估了多中心晚期非小细胞肺癌患者从一线到三线全身抗癌治疗的医疗保健资源使用情况。回顾性图表回顾研究。
符合条件的患者年龄在20岁或以上,患有不可切除的局部晚期/转移性NSCLC,没有已知的可行基因组改变,他们从2017年7月1日至2018年12月20日在日本23家医院开始了一线全身抗癌治疗。我们计算了每个资源使用记录的患者百分比,每个资源的总数,以及从第一次开始随访以来每100名患者周的资源使用情况,第二-,和三线治疗,总体而言,按3个最常见的方案类别,即,ICI单一疗法,铂双联化疗(无伴随ICI),和非铂细胞毒性方案(非铂)。研究随访截至2019年9月30日。
■在1208例患者中(中位年龄=70岁;975[81%]男性),463例患者(38%)接受ICI单药治疗,647(54%)接受铂双联化疗,98例(8%)接受非铂方案作为一线治疗.在研究期间,621名(51%)患者开始二线治疗,和281(23%)开始三线治疗。在每个治疗线路中,大多数患者经历了≥1次住院(76%-94%)和≥1次门诊(85%-90%)。住院人数从一线的每100名患者周6.5增加到三线的每100名患者周8.0。在一线治疗期间,在接受ICI单药治疗的患者中,每100例患者-周的住院次数分别为4.8,8.4和6.5,铂双合化疗,和非铂疗法,分别,以及归类为归因于NSCLC治疗管理的住院百分比(无手术,procedure,治疗转移,或姑息性肺放射)为64%,77%,73%,分别。门诊量从一线治疗的43.0/100患者周增加到三线治疗的51.4/100患者周。在一线治疗期间,对于接受ICI单药治疗的患者,每100例患者-周的门诊量分别为41.0、46.7和33.0,铂双合化疗,和非铂疗法,分别,门诊输液治疗的百分比为48%,34%,36%,分别。
■这项研究的结果,虽然只是描述性的,在日本晚期非小细胞肺癌的3种常见全身抗癌治疗方案中,一线治疗期间医疗保健资源的使用模式不同,这表明需要进一步的研究来调查不同治疗方案之间的这些明显差异。
UNASSIGNED: First-line immune checkpoint inhibitor (ICI) monotherapy for advanced non-small cell lung cancer (NSCLC) was introduced in Japan in February 2017. Limited information is available since that time regarding health care resource use for NSCLC in Japan, where the hospitalization burden is high.
UNASSIGNED: We evaluated health care resource use from first- through third-line systemic anticancer therapy for patients with advanced NSCLC included in a multicenter, retrospective chart review study.
UNASSIGNED: Eligible patients were aged 20 years or older with unresectable locally advanced/metastatic NSCLC with no known actionable genomic alteration who initiated first-line systemic anticancer therapy from July 1, 2017, to December 20, 2018, at 23 Japanese hospitals. We calculated the percentage of patients with a record of each resource used, the total number of each resource, and the resource use per 100 patient-weeks of follow-up from initiation of first-, second-, and third-line therapy, overall and by the 3 most common regimen categories, namely, ICI monotherapy, platinum-doublet chemotherapy (without concomitant ICI), and nonplatinum cytotoxic regimens (nonplatinum). Study follow-up ended September 30, 2019.
UNASSIGNED: Among 1208 patients (median age = 70 years; 975 [81%] men), 463 patients (38%) received ICI monotherapy, 647 (54%) received platinum-doublet chemotherapy, and 98 (8%) received nonplatinum regimens as first-line therapy. During the study, 621 (51%) patients initiated second-line, and 281 (23%) initiated third-line therapy. The majority of patients experienced ≥1 hospitalization (76%-94%) and ≥1 outpatient visit (85%-90%) during each therapy line. The number of hospitalizations increased from 6.5 per 100 patient-weeks in first-line to 8.0 per 100 patient-weeks in third-line. During first-line therapy, the number of hospitalizations per 100 patient-weeks were 4.8, 8.4, and 6.5 for patients receiving ICI monotherapy, platinum-doublet chemotherapy, and nonplatinum regimens, respectively, and the percentages of hospitalizations categorized as attributable to NSCLC treatment administration (no surgery, procedure, treatment of metastasis, or palliative lung radiation) were 64%, 77%, and 73%, respectively. The number of outpatient visits increased from 43.0 per 100 patient-weeks in first-line to 51.4 per 100 patient-weeks in third-line therapy. During first-line therapy, outpatient visits per 100 patient-weeks were 41.0, 46.7, and 33.0 for patients receiving ICI monotherapy, platinum-doublet chemotherapy, and nonplatinum regimens, respectively, and the percentages of outpatient visits for infusion therapy were 48%, 34%, and 36%, respectively.
UNASSIGNED: The results of this study, although solely descriptive, showed differing patterns of health care resource use during first-line therapy among the 3 common systemic anticancer therapy regimens for advanced NSCLC in Japan and suggest that further research is needed to investigate these apparent differences by treatment regimen.