Campbell David, O'Day Ken, Hertel Nadine, Penrod John R, Manley Daumont Melinda, Lees Michael
Xcenda LLC, Palm Harbor, Florida, USA.
Worldwide Health Economics and Outcomes Research, Bristol-Myers Squibb Pharmaceuticals Ltd, Uxbridge, UK.
Popul Health Metr. 2018 Nov 26;16(1):17. doi: 10.1186/s12963-018-0174-4.
The burden of advanced non-small cell lung cancer (NSCLC) is not well understood, and the number of patients likely to receive treatment in Europe has not been quantified. The aim of this study was to forecast the annual number of patients with squamous and non-squamous advanced NSCLC likely to receive second and third lines of therapy (LOT) from 2016 to 2020 in France, Germany, Italy, and Spain.
A patient count model (PCM) was developed in Microsoft Excel to estimate the number of patients with refractory advanced NSCLC eligible to receive systemic treatment. Using historical population-based cancer registry data, segmented linear regression ("Joinpoint") was used to forecast age- and sex-stratified lung cancer incidence rates in each country through 2020. Yearly incident case count totals by country were apportioned according to NSCLC histology and stage at diagnosis. Country-specific treatment rates came from a recent medical chart review study, and early- to advanced-stage disease progression rates were estimated over a 10-year interval. A probabilistic sensitivity analysis (PSA) was performed to estimate variability in the patient counts.
The combined number of squamous and non-squamous advanced NSCLC patients estimated to receive second and third LOT, respectively, in 2016 were France = 11,600 and 3500; Germany = 15,100 and 4900; Italy = 13,500 and 2500; Spain = 9400 and 2100. The forecasted numbers of patients receiving second and third LOT, respectively, in 2020 were France = 13,900 and 4200; Germany = 16,200 and 5200; Italy = 15,100 and 2600; Spain = 11,000 and 2500.
Driven by growth in the incidence of NSCLC among women, the model forecasts an overall increase in the number of patients with advanced-stage squamous and non-squamous NSCLC likely to receive systemic treatment in the year 2020. The results highlight the significant burden of refractory advanced NSCLC and the need for more robust surveillance data to accurately quantify the burden of disease.
晚期非小细胞肺癌（NSCLC）的负担尚未得到充分了解，欧洲可能接受治疗的患者数量也未被量化。本研究的目的是预测2016年至2020年法国、德国、意大利和西班牙可能接受二线和三线治疗（LOT）的鳞状和非鳞状晚期NSCLC患者的年度数量。
在Microsoft Excel中开发了一个患者计数模型（PCM），以估计有资格接受全身治疗的难治性晚期NSCLC患者数量。利用基于人群的历史癌症登记数据，采用分段线性回归（“Joinpoint”）预测每个国家到2020年按年龄和性别分层的肺癌发病率。各国每年的发病病例总数根据NSCLC的组织学类型和诊断时的分期进行分配。各国特定的治疗率来自最近的一项病历回顾研究，并在10年的时间间隔内估计了早期到晚期疾病的进展率。进行了概率敏感性分析（PSA）以估计患者数量的变异性。
2016年估计分别接受二线和三线LOT的鳞状和非鳞状晚期NSCLC患者的合并数量为：法国 = 11,600和3500；德国 = 15,100和4900；意大利 = 13,500和2500；西班牙 = 9400和2100。2020年预测分别接受二线和三线LOT的患者数量为：法国 = 13,900和4200；德国 = 16,200和5200；意大利 = 15,100和2600；西班牙 = 11,000和2500。
受女性NSCLC发病率增长的推动，该模型预测2020年可能接受全身治疗的晚期鳞状和非鳞状NSCLC患者数量将总体增加。结果突出了难治性晚期NSCLC的重大负担以及需要更可靠的监测数据来准确量化疾病负担。
