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@article{1686540,
author = {Brat, Kristián and Bratová, Monika and Skřičková, Jana and Bařinová, Magda and Hurdálková, Karolína and Pesek, Milos and Havel, Libor and Koubkova, Leona and Hrnciarik, Michal and Krejci, Jana and Fischer, Ondrej and Zemanova, Milada and Coupkova, Helena and Svaton, Martin},
article_location = {HOBOKEN},
article_number = {11},
doi = {http://dx.doi.org/10.1111/1759-7714.13679},
keywords = {Anticancer treatment; non-small cell lung cancer; progression-free survival; real-life effectiveness; tyrosinkinase inhibitors},
language = {eng},
issn = {1759-7706},
journal = {THORACIC CANCER},
title = {Real-life effectiveness of first-line anticancer treatments in stageIIIB/IV NSCLCpatients: Data from theCzechTULUNG Registry},
url = {https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1759-7714.13679},
volume = {11},
year = {2020}
}
TY - JOUR
ID - 1686540
AU - Brat, Kristián - Bratová, Monika - Skřičková, Jana - Bařinová, Magda - Hurdálková, Karolína - Pesek, Milos - Havel, Libor - Koubkova, Leona - Hrnciarik, Michal - Krejci, Jana - Fischer, Ondrej - Zemanova, Milada - Coupkova, Helena - Svaton, Martin
PY - 2020
TI - Real-life effectiveness of first-line anticancer treatments in stageIIIB/IV NSCLCpatients: Data from theCzechTULUNG Registry
JF - THORACIC CANCER
VL - 11
IS - 11
SP - 3346-3356
EP - 3346-3356
PB - WILEY
SN - 17597706
KW - Anticancer treatment
KW - non-small cell lung cancer
KW - progression-free survival
KW - real-life effectiveness
KW - tyrosinkinase inhibitors
UR - https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1759-7714.13679
L2 - https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1759-7714.13679
N2 - 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.
ER -
BRAT, Kristián, Monika BRATOVÁ, Jana SKŘIČKOVÁ, Magda BAŘINOVÁ, Karolína HURDÁLKOVÁ, Milos PESEK, Libor HAVEL, Leona KOUBKOVA, Michal HRNCIARIK, Jana KREJCI, Ondrej FISCHER, Milada ZEMANOVA, Helena COUPKOVA and Martin SVATON. Real-life effectiveness of first-line anticancer treatments in stageIIIB/IV NSCLCpatients: Data from theCzechTULUNG Registry. \textit{THORACIC CANCER}. HOBOKEN: WILEY, 2020, vol.~11, No~11, p.~3346-3356. ISSN~1759-7706. Available from: https://dx.doi.org/10.1111/1759-7714.13679.
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