International PhD Program in Biotech and Healthcare Management, College of Management, Taipei Medical University, Taipei, Taiwan
Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
BMJ Open. 2020 May 10;10(5):e033427. doi: 10.1136/bmjopen-2019-033427.
Two oral targeted therapies, gefitinib and erlotinib, were first approved and then launched into the market for treatment of late-stage non-small cell lung cancer (NSCLC) in Taiwan in 2003 and 2006, respectively. The aim of this study were to determine the trends in lung cancer burden and examine changes in lung cancer-related survival rates and mortality following the launch of these new drugs.
Yearly lung cancer-related data (1994-2013), including incidence, number of newly diagnosed patients, survival rate and mortality, were retrieved from the Taiwan Cancer Registry Database.
Using a time series design with autoregressive integrated moving average model, we investigated and projected trends in the incidence and early diagnosis of lung cancer in Taiwan. We also estimated the changes in survival rates and mortality following the launch of targeted therapies using interrupted time series and segmented regression models.
The age-standardised incidence of lung cancer increased from 22.53 per 100 000 people in 1994 to 34.09 in 2013, and it was projected to reach 38.98 by 2020. The rate of early-stage NSCLC at diagnosis increased from 12.63% in 2004 to 23.99% in 2013, and it was projected to reach 32.95% by 2020. The 2-year lung cancer survival increased by 19.81% (95% CI 14.90% to 24.71%) 3 years following the launch of gefitinib. Lung cancer mortality declined by 5.97% (95% CI -8.20% to -3.73%) 3 years following the launch of gefitinib.
Lung cancer survival rate increased and mortality decreased significantly following the launch of gefitinib and erlotinib in Taiwan.
两种口服靶向药物，吉非替尼和厄洛替尼，分别于 2003 年和 2006 年在台湾获得批准并投放市场，用于治疗晚期非小细胞肺癌（NSCLC）。本研究旨在确定肺癌负担的趋势，并检查这些新药推出后肺癌相关生存率和死亡率的变化。
从台湾癌症登记数据库中检索了 1994 年至 2013 年的肺癌相关年度数据（包括发病率、新诊断患者人数、生存率和死亡率）。
我们使用自回归综合移动平均模型的时间序列设计，调查并预测了台湾肺癌发病率和早期诊断的趋势。我们还使用中断时间序列和分段回归模型估计了靶向治疗推出后生存率和死亡率的变化。
肺癌的年龄标准化发病率从 1994 年的每 100000 人 22.53 例增加到 2013 年的 34.09 例，预计到 2020 年将达到 38.98 例。诊断时早期非小细胞肺癌的比例从 2004 年的 12.63%增加到 2013 年的 23.99%，预计到 2020 年将达到 32.95%。吉非替尼推出后 3 年，肺癌 2 年生存率提高了 19.81%（95%可信区间 14.90%至 24.71%）。吉非替尼推出后 3 年，肺癌死亡率下降了 5.97%（95%可信区间-8.20%至-3.73%）。
吉非替尼和厄洛替尼在台湾推出后，肺癌生存率显著提高，死亡率显著下降。
