J 2020

Real-life effectiveness of first-line anticancer treatments in stageIIIB/IV NSCLCpatients: Data from theCzechTULUNG Registry

BRAT, Kristián, Monika BRATOVÁ, Jana SKŘIČKOVÁ, Magda BAŘINOVÁ, Karolína HURDÁLKOVÁ et. al.

Základní údaje

Originální název

Real-life effectiveness of first-line anticancer treatments in stageIIIB/IV NSCLCpatients: Data from theCzechTULUNG Registry

Autoři

BRAT, Kristián (703 Slovensko, domácí), Monika BRATOVÁ (203 Česká republika, garant, domácí), Jana SKŘIČKOVÁ (203 Česká republika, domácí), Magda BAŘINOVÁ (203 Česká republika), Karolína HURDÁLKOVÁ (203 Česká republika), Milos PESEK (203 Česká republika), Libor HAVEL (203 Česká republika), Leona KOUBKOVA (203 Česká republika), Michal HRNCIARIK (203 Česká republika), Jana KREJCI (203 Česká republika), Ondrej FISCHER (203 Česká republika), Milada ZEMANOVA (203 Česká republika), Helena COUPKOVA (203 Česká republika) a Martin SVATON (203 Česká republika)

Vydání

THORACIC CANCER, HOBOKEN, WILEY, 2020, 1759-7706

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30203 Respiratory systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 3.500

Kód RIV

RIV/00216224:14110/20:00116717

Organizační jednotka

Lékařská fakulta

UT WoS

000574908600001

Klíčová slova anglicky

Anticancer treatment; non-small cell lung cancer; progression-free survival; real-life effectiveness; tyrosinkinase inhibitors

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 11. 11. 2020 11:30, Mgr. Tereza Miškechová

Anotace

V originále

Background Data regarding real-life effectiveness of any treatment may improve clinical decision-making. The aim of this study was to evaluate real-life effectiveness of tyrosin-kinase inhibitors, bevacizumab and pemetrexed as first-line treatments in patients with advanced/metastatic non-small cell lung cancer (NSCLC). Methods We analyzed data of 2157 patients of the Czech TULUNG Registry of patients with advanced/metastatic NSCLC who received modern-era treatments between 2011 and 2018. Patients treated with gefitinib, erlotinib, afatinib, bevacizumab (+ maintenance), pemetrexed (+ maintenance) as first-line therapy were included in the study. A systematic literature search separately identified clinical trials suitable for calculation of comparator pooled OS and PFS for each regimen. For each subgroup, basic characteristics and survival data (Kaplan-Meier estimates) are shown. We propose the "index of real-life effectiveness" (IRE), a ratio of real-life OS/PFS and comparator pooled OS/PFS. Univariate and multivariate logistic regression identified factors were associated with longer OS (ie, IRE>1.1). Results Survival analysis showed median OS of 23 months for erlotinib, 29.3 months for afatinib, 19.6 months for gefitinib, 12.2 months for pemetrexed, 17.5 months for pemetrexed maintenance, 15.8 months for bevacizumab and 15.8 months for bevacizumab maintenance. Calculated IREs for OS for the regimens were: erlotinib 1.013, afatinib 1.184, gefitinib 0.736, pemetrexed 1.188, pemetrexed maintenance 1.294, bevacizumab 1.178, and bevacizumab maintenance 1.189. Multivariate regression analysis showed that these factors were associated with longer OS: lower PS for afatinib; lower PS, absence of adverse events and female sex for bevacizumab; and lower PS and female sex for pemetrexed. Conclusions This study clearly demonstrated that real-life effectiveness of certain treatment regimens may strongly differ in various populations/health care systems, and comparison between TULUNG data and pooled survival data from trials showed higher real-life effectiveness for most of the studied first-line regimens. Lower ECOG PS, younger age, female sex and adverse events were associated with longer survival in most regimens. Key pointsSignificant findings of the study Comparison between TULUNG data and pooled survival data from trials showed higher real-life effectiveness for most of the studied first-line regimens; for most regimens, lower ECOG PS, younger age, female sex and adverse events were associated with longer survival. What this study adds Real-life effectiveness of certain treatment regimens may strongly differ in various populations/health care systems.