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.

Basic information

Original name

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

Authors

BRAT, Kristián (703 Slovakia, belonging to the institution), Monika BRATOVÁ (203 Czech Republic, guarantor, belonging to the institution), Jana SKŘIČKOVÁ (203 Czech Republic, belonging to the institution), Magda BAŘINOVÁ (203 Czech Republic), Karolína HURDÁLKOVÁ (203 Czech Republic), Milos PESEK (203 Czech Republic), Libor HAVEL (203 Czech Republic), Leona KOUBKOVA (203 Czech Republic), Michal HRNCIARIK (203 Czech Republic), Jana KREJCI (203 Czech Republic), Ondrej FISCHER (203 Czech Republic), Milada ZEMANOVA (203 Czech Republic), Helena COUPKOVA (203 Czech Republic) and Martin SVATON (203 Czech Republic)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30203 Respiratory systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.500

RIV identification code

RIV/00216224:14110/20:00116717

Organization unit

Faculty of Medicine

UT WoS

000574908600001

Keywords in English

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

Tags

Tags

International impact, Reviewed
Změněno: 11/11/2020 11:30, Mgr. Tereza Miškechová

Abstract

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.