Kent Seamus, Mpofu Philani, Duffield Stephen, Adam Jane, Beal Brennan, Royce Trevor J, Adamson Blythe, Kasturi Jyotsna, Sujenthiran Arun, Jónsson Páll
Flatiron Health UK Ltd, London, UK.
Flatiron Health Inc, New York, New York, USA
BMJ Open. 2024 Dec 7;14(12):e085722. doi: 10.1136/bmjopen-2024-085722.
The objective of this study is to explore how the UK versus the USA compare in patient characteristics, treatment patterns and overall survival (OS) of patients with advanced non-small cell lung cancer (aNSCLC) initiating first-line (1L) treatment.
Retrospective cohort study.
Oncology treatment centres in the USA and UK.
People in the USA and UK diagnosed with aNSCLC and treated in the 1L setting between 2016 and 2018. The US cohort was obtained from a nationwide electronic health record-derived deidentified database. The UK cohort information was derived from a published study exploring the patient characteristics, treatments and outcomes of people with aNSCLC in the UK.
1L chemotherapy, immunotherapy monotherapy or targeted therapy.
The primary outcome was OS-defined as the time from treatment initiation to death from any cause.
There were 1003 patients in the UK and 3819 in the US cohorts receiving 1L therapy for aNSCLC. After standardising the US cohort to the UK cohort, median OS in the USA and UK was similar across 1L drug classes: chemotherapies (7.7 (95% CI 7.1 to 8.3) vs 8.1 (95% CI 7.4 to 8.9) months), immunotherapies (13.9 (95% CI 11.0 to 17.1) vs 14.0 (95% CI 10.7 to 20.6)) and targeted therapies (21.6 (95% CI 18.5 to 23.7) vs 20.2 (95% CI 16.0 to 30.5)). OS curves for 1L immunotherapy and targeted therapy were almost overlapping after standardisation. OS after around 12 months was higher in US patients compared with UK patients receiving 1L chemotherapy regimens. Of those receiving 1L chemotherapy, the proportion receiving any second-line therapy appeared higher for patients in the USA versus UK.
The results suggest that in aNSCLC patients receiving 1L treatment, US data have the potential to be used in technology evaluations to understand long-term OS where UK data are unavailable or sparse.
本研究旨在探讨在开始一线（1L）治疗的晚期非小细胞肺癌（aNSCLC）患者中，英国与美国在患者特征、治疗模式和总生存期（OS）方面的比较情况。
回顾性队列研究。
美国和英国的肿瘤治疗中心。
2016年至2018年间在美国和英国被诊断为aNSCLC并接受1L治疗的患者。美国队列数据来自一个全国性的、源自电子健康记录的去识别数据库。英国队列信息来自一项已发表的研究，该研究探讨了英国aNSCLC患者的特征、治疗方法和预后情况。
1L化疗、免疫治疗单药治疗或靶向治疗。
主要结局为OS，定义为从治疗开始至因任何原因死亡的时间。
英国队列中有1003例患者，美国队列中有3819例患者接受了aNSCLC的1L治疗。将美国队列标准化至英国队列后，美国和英国在1L药物类别中的中位OS相似：化疗（7.7（95%CI 7.1至8.3）个月对8.1（95%CI 7.4至8.9）个月）、免疫治疗（13.9（95%CI 11.0至17.1）对14.0（95%CI 10.7至20.6））和靶向治疗（21.6（95%CI 18.5至23.7）对20.2（95%CI 16.0至30.5））。标准化后，1L免疫治疗和靶向治疗的OS曲线几乎重叠。接受1L化疗方案的美国患者在大约12个月后的OS高于英国患者。在接受1L化疗的患者中，美国患者接受任何二线治疗的比例似乎高于英国患者。
结果表明，在接受1L治疗的aNSCLC患者中，当英国数据不可用或稀少时，美国数据有可能用于技术评估以了解长期OS情况。
