BackgroundThe aim of this study was to conduct a retrospective database analysis to describe the chemotherapy treatment patterns and outcomes of patients with gastric cancer.MethodsIndividuals diagnosed with gastric cancer were identified from the IMS Oncology Database, which contains electronic medical record (EMR) data collected from a variety of community practices, and the Truven Health MarketScan® Research database, an administrative claims database. Eligible patients were 18 years of age or older and had an ICD-9 code 151.0–151.9. Patients were excluded if they had evidence of cancer within 6 months of the index diagnosis.ResultsThere were 5257 eligible patients identified in EMR data: 1982 (37.7 %) of these patients also had data regarding chemotherapy treatments. Of the 1982 patients who received first-line therapy, 42.3 %, 18.1 %, and 7.9 % went on to receive a second, third, and fourth line of chemotherapy, respectively. There were 11891 eligible patients identified in the administrative database; 5299 (44.6 %) had data regarding chemotherapy. Of those initiating chemotherapy, 2888 (54.5 %) received a second line and 1598 (30.2 %) received a third line of treatment. The average total cost of care during first-line therapy was $40,811 [standard deviation (SD) = $49,916], which was incurred over an average of 53.5 (SD = 63.4) days. A similar pattern was evident in second-line treatment (mean/SD, $26,588/$33,301) over 41.2 (SD = 55.7) days.ConclusionsCosts and duration of care received vary among gastric cancer patients in the U.S. There is a need to understand which regimens may be associated with better health outcomes and to standardize treatment as appropriate.
Aim: To describe treatment patterns and outcomes for advanced/metastatic non-small-cell lung cancer (aNSCLC) treated with single-agent or combination ramucirumab (ramucirumab-based) and/or immune checkpoint inhibitor (ICI-based) therapy. Materials & methods: Retrospective study of aNSCLC patients (n = 4054) identified in the Flatiron Health database, who received at least two treatment lines including ramucirumab- and/or ICI-based regimens between December 2014 and May 2017. Results: Median overall survival (95% CI) from aNSCLC diagnosis was 29.3 (25.5–33.0) months for patients receiving sequential ramucirumab- and ICI-based therapy (n = 245), 15.1 (12.6–18.2) months for patients receiving sequences including ramucirumab- without ICI-based therapy (n = 112), and 23.1 (21.9–24.2) months for patients receiving ICI-based therapy without ramucirumab-based therapy in sequence (n = 3697). Conclusion: Results provide real-world survival estimates for aNSCLC treated with sequences including ramucirumab- and/or ICI-based therapies.
Long-term use of continuation maintenance pemetrexed was well tolerated; resource use was low, corresponding with known pemetrexed toxicities. The EQ-5D results demonstrate that patients tolerate long-term maintenance pemetrexed without worsening QoL.
This retrospective observational study was designed to evaluate overall survival
in a real-world patient population and to identify predictive factors associated
with receipt of second-line therapy. A retrospective analysis of electronic
medical records (Flatiron Health, New York) was conducted among patients
initiating first-line therapy from January 1, 2013, through April 30, 2018.
Eligible patients were diagnosed with advanced gastric, gastroesophageal
junction, or esophageal adenocarcinoma and ≥18 years of age at the time of
treatment initiation. Patients alive 45 days after discontinuation of first-line
therapy were considered potentially eligible for continued therapy and were
categorized into those who received and those who did not receive second-line
therapy. Survival analyses were conducted using Kaplan-Meier method and log-rank
test without adjusting for any baseline covariates. Factors associated with
further treatment were evaluated using logistic regression. A total of 3850
patients met eligibility criteria. Among the 2516 patients available to receive
second-line therapy, 1515 (60.2%) received second-line therapy and 1001 (39.8%)
did not receive further therapy. Among those potentially eligible to receive
second-line therapy, median survival was 15.4 months (95% confidence interval
[CI]: 14.6-16.0) from initiation of first-line therapy for those who received
second-line therapy and 10.0 months (95% CI: 9.3-10.7) for those who did not.
Longer duration of first-line therapy (≥169 vs ≤84 days), HER2-positive tumors,
initially diagnosed with stage IV disease, less weight loss during first-line
therapy, and younger age were associated with receipt of second-line therapy
(all
P
< .001). Longer survival was associated with multiple
lines of therapy; however, these results should be interpreted with caution, and
no causal relationship can be inferred.
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