表皮生长因子受体突变型晚期非小细胞肺癌患者的特征、检测和治疗模式及结局:一项多国真实世界研究。
Patient Characteristics, Testing and Treatment Patterns, and Outcomes in EGFR-Mutated Advanced Non-Small Cell Lung Cancer: A Multinational, Real-World Study.
机构信息
Value, Evidence, and Outcomes-Oncology, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA.
Adelphi Real World, Bollington, UK.
出版信息
Adv Ther. 2023 Jul;40(7):3135-3168. doi: 10.1007/s12325-023-02530-0. Epub 2023 May 23.
INTRODUCTION
Treatment landscape for advanced/metastatic NSCLC (aNSCLC) has evolved considerably over the past few decades with the advent of targeted therapies for epidermal growth factor receptor-mutated (EGFRm+) aNSCLC treatment. This study described real-world patient and disease characteristics, treatment and practice patterns, and clinical, economic, and patient-reported outcomes (PROs) in patients with EGFRm+ aNSCLC.
METHODS
Data were derived from the Adelphi NSCLC Disease Specific Programme™ (DSP™), a point-in-time survey conducted between July and December 2020. The survey included oncologists and pulmonologists, and their consulting patients (with physician-confirmed EGFRm+ aNSCLC) from nine countries: the US, Brazil, the UK, Italy, France, Spain, Germany, Japan, and Taiwan. All analyses were descriptive.
RESULTS
Overall, 542 physicians reported data for 2857 patients (mean age 65.6 years), and most patients were female (56.0%), white (61.0%), and had stage IV disease at initial diagnosis (76.0%), and adenocarcinoma histology (89.0%). Most patients received EGFR-tyrosine kinase inhibitors (TKI) therapy in first- (91.0%), second- (74.0%), and third-line (67.0%). The most common tumor samples and methods for EGFR detection were EGFR-specific mutation detection tests (44.0%) and core needle biopsy (56.0%). Median time to next treatment was 14.0 (IQR 8.0-22.0) months and disease progression was the main physician-reported reason for early discontinuation. The most common physician-reported disease symptoms were cough (51.0%), fatigue (37.0%), and dyspnea (33.0%). In patients assessed for PROs, mean EQ-5D-5L index and FACT-L health utility scores were 0.71 and 83.5, respectively. On average, patients lost 10.6 h of work/week for approximately 29.2 weeks due to EGFRm+ aNSCLC.
CONCLUSION
This real-world multinational data set showed that most patients with EGFRm+ aNSCLC were treated per the country relevant clinical guidelines, with progression as the main reason for early treatment discontinuation. For the included countries, these findings may offer a useful benchmark for decision makers to determine future allocation of healthcare resources for patients with EGFRm+ aNSCLC.
简介
在过去几十年中,随着针对表皮生长因子受体突变(EGFRm+)的晚期/转移性非小细胞肺癌(aNSCLC)治疗的靶向治疗的出现,晚期/转移性非小细胞肺癌(aNSCLC)的治疗格局发生了重大变化。本研究描述了 EGFRm+ aNSCLC 患者的真实患者和疾病特征、治疗和实践模式以及临床、经济和患者报告的结果(PROs)。
方法
数据来自 Adelphi NSCLC 疾病专项计划(DSP),这是一项在 2020 年 7 月至 12 月期间进行的时点调查。该调查包括肿瘤学家和肺病学家,以及来自九个国家的咨询患者(经医生确认患有 EGFRm+ aNSCLC):美国、巴西、英国、意大利、法国、西班牙、德国、日本和中国台湾。所有分析均为描述性的。
结果
总体而言,542 名医生报告了 2857 名患者的数据(平均年龄 65.6 岁),大多数患者为女性(56.0%),白人(61.0%),初诊时为 IV 期疾病(76.0%),腺癌组织学(89.0%)。大多数患者接受 EGFR 酪氨酸激酶抑制剂(TKI)治疗,包括一线(91.0%)、二线(74.0%)和三线(67.0%)。最常见的肿瘤样本和 EGFR 检测方法是 EGFR 特异性突变检测试验(44.0%)和核心针活检(56.0%)。下一次治疗的中位时间为 14.0(IQR 8.0-22.0)个月,疾病进展是医生报告早期停药的主要原因。医生报告最常见的疾病症状是咳嗽(51.0%)、疲劳(37.0%)和呼吸困难(33.0%)。在接受 PROs 评估的患者中,平均 EQ-5D-5L 指数和 FACT-L 健康效用评分分别为 0.71 和 83.5。平均而言,由于 EGFRm+ aNSCLC,患者每周损失 10.6 小时的工作/周,大约 29.2 周。
结论
这项真实世界的多国数据表明,大多数 EGFRm+ aNSCLC 患者的治疗符合各国相关临床指南,疾病进展是早期治疗停药的主要原因。对于包括的国家/地区,这些发现可能为决策者提供有用的基准,以确定未来对 EGFRm+ aNSCLC 患者的医疗保健资源分配。
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