Franchi Matteo, Cortinovis Diego, Corrao Giovanni
National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milan, Italy.
Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy.
Cancers (Basel). 2021 Jul 29;13(15):3809. doi: 10.3390/cancers13153809.
We aimed at describing treatment pathways, clinical outcomes and healthcare costs of advanced non-small cell lung cancer (NSCLC) patients in Lombardy Region, Italy. Using healthcare administrative data, 37,562 patients with a new diagnosis of lung cancer between 2012 and 2019 were identified. Among these, patients who started a first-line treatment for advanced NSCLC with either pembrolizumab ( = 660) or tyrosine-kinase inhibitors (TKI) ( = 1245) before 30 June 2020 were included in the study cohort and followed-up until 31 December 2020. Among pembrolizumab users, median time-to-treatment failure (TTF) and median overall survival (OS) were 3.2 months and 13.6 months, respectively. About one third (34.1%) switched to second-line treatment (chemotherapy for all of them). Among TKI users, median TTF and median OS were 9.3 months and 18.4 months, respectively, and 37.1% of patients started second-line treatment (17.8% with TKI and 19.2% with chemotherapy). Average per-patient cumulative healthcare costs during the first year after first-line treatment start were 51,735 € and 30,708 €, respectively, in pembrolizumab and TKI first-line users. These results are coherent with those reported from other real--world studies and may help both clinicians and health decision makers.
我们旨在描述意大利伦巴第地区晚期非小细胞肺癌（NSCLC）患者的治疗路径、临床结局和医疗保健成本。利用医疗管理数据，识别出2012年至2019年间37562例新诊断为肺癌的患者。其中，在2020年6月30日前开始使用派姆单抗（n = 660）或酪氨酸激酶抑制剂（TKI）（n = 1245）进行晚期NSCLC一线治疗的患者被纳入研究队列，并随访至2020年12月31日。在使用派姆单抗的患者中，治疗失败时间（TTF）中位数和总生存期（OS）中位数分别为3.2个月和13.6个月。约三分之一（34.1%）的患者转为二线治疗（均为化疗）。在使用TKI的患者中，TTF中位数和OS中位数分别为9.3个月和18.4个月，37.1%的患者开始二线治疗（17.8%使用TKI，19.2%使用化疗）。派姆单抗和TKI一线治疗患者在一线治疗开始后第一年的人均累计医疗保健成本分别为51735欧元和30708欧元。这些结果与其他真实世界研究报告的结果一致，可能对临床医生和卫生决策者都有帮助。
