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Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2019 ASCO Annual Meeting but not presented at the Meeting, can be found online only.

Real-world treatment patterns, survival, and cost among elderly patients with small-cell lung cancer (SCLC).

Sub-category:
Metastatic Non-Small Cell Lung Cancer

Category:
Lung Cancer—Non-Small Cell Metastatic

Meeting:
2019 ASCO Annual Meeting

Abstract No:
e20647

Citation:
J Clin Oncol 37, 2019 (suppl; abstr e20647)

Author(s): Changxia Shao, Jinghua He, Sumesh Kachroo, Fan Jin; Merck & Co., Inc., North Wales, PA; Merck & Co., Inc, North Wales, PA; Merck & Co, Inc., Rahway, NJ; Merck & Co., Inc., Kenilworth, NJ

Abstract Disclosures

Abstract:

Background: Given a dearth of literature, this study aimed to investigate real-world use of systemic therapies, survival, and costs among elderly SCLC patients (pts) in U.S. Methods: Pts (65+ years old) with an initial diagnosis of SCLC during 2007-2013 were identified using the SEER-Medicare data. Overall survival (OS), duration of treatment (DOT) and time to next treatment (TTNT) were estimated based on the Kaplan-Meier method. Costs (2016 US dollars) were derived from Medicare claims. Results: A total of 11 812 pts were identified with 7 797 (66%) being stage IV at diagnosis. During an average of 10 months (m) follow-up post diagnosis, 6 509 (55%), 2 238 (19%) and 679 (6%) received first line (1L), 2L and 3L therapy, respectively. The median OS was 9 m from 1L start and 6 m from 2L or 3L start, suggesting existing treatment providing limited survival benefit. Majority pts (93%) received platinum-based therapy for 1L with Car + etoposide (Eto, 59%) being the most commonly used regimen, followed by Cis + Eto (18%) and Car monotherapy (8%). Car + Eto, Top and Pac were the top 3 regimens used in 2L and 3L. Median DOTs were 4-6 m, yet TTNT ranged from 7 to 18 m across lines of therapy. The average per person per month (PPPM) costs were $9.4k for 1L, $8.9k for 2L, and $8.8k for 3L. Conclusions: Advanced SCLC remains an aggressive malignancy with poor prognosis, lack of ideal therapy and high medical cost, which highlighted high unmet medical need of SCLC among elderly pts.

Regimens*1L
2L
3L
n (%)Median DOTMedian TTNTMean PPPM costn (%)Median DOTMedian TTNTMean PPPM costn (%)Median DOTMedian TTNTMean PPPM cost
Cisplatin (Cis)1 445 (22.2%)5.217.99 302238 (10.6%)4.111.58 10262 (9.1%)5.27.47 633
Carboplatin (Car)4 622 (71.0%)5.814.39 292844 (37.7%)4.715.58 295148 (21.8%)5.314.28 630
Topotecan (Top)22 (0.3%)5.515.69 852502 (22.4%)4.5910 000127 (18.7%)4.16.99 585
Irinotecan (Iri)36 (0.6%)4.8--137 (6.1%)5.59.99 71752 (7.7%)4.712.89 584
Paclitaxel (Pac)19 (0.3%)4.4--264 (11.8%)5.39.79 133158 (23.3%)4.98.98 626
Docetaxel (Doc)2 (0.0%)---39 (1.7%)4.7-10 13427 (4.0%)5.37.18 112
Other363 (5.6%)4.110.610 065214 (9.6%)4.2128 999105 (15.5%)56.78 855

*Mutually-exclusive categories with listed drug as mono or combination therapy

 
Other Abstracts in this Sub-Category:

 

1. Association of STK11/LKB1 genomic alterations with lack of benefit from the addition of pembrolizumab to platinum doublet chemotherapy in non-squamous non-small cell lung cancer.

Meeting: 2019 ASCO Annual Meeting Abstract No: 102 First Author: Ferdinandos Skoulidis
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer

 

2. Real-world outcomes of patients with advanced non-small cell lung cancer (aNSCLC) and autoimmune disease (AD) receiving immune checkpoint inhibitors (ICIs).

Meeting: 2019 ASCO Annual Meeting Abstract No: 110 First Author: Sean Khozin
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer

 

3. RELAY: A multinational, double-blind, randomized Phase 3 study of erlotinib (ERL) in combination with ramucirumab (RAM) or placebo (PL) in previously untreated patients with epidermal growth factor receptor mutation-positive (EGFRm) metastatic non-small cell lung cancer (NSCLC).

Meeting: 2019 ASCO Annual Meeting Abstract No: 9000 First Author: Kazuhiko Nakagawa
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer

 

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