AI Article Synopsis
- - The study analyzed first-line platinum-based chemotherapy treatments for advanced non-small cell lung cancer (NSCLC) using real-world data from U.S. oncology electronic medical records between September 2008 and November 2014.
- - The most common regimens included Paclitaxel/Carboplatin and Pemetrexed-based combinations, with a focus on adverse events like anemia, neutropenia, nausea, and vomiting, showing variable safety outcomes among regimens.
- - Results indicated that some combinations had lower risks of anemia compared to Pac/Carbo, while Pem/Cis was linked to higher rates of nausea and vomiting, suggesting that chemotherapy choices should be informed by real-world safety data.
Article Abstract
Background: We analyzed the treatment patterns and safety outcomes of the most common first-line platinum-based regimens initiated on or after non-small cell lung cancer (NSCLC) diagnosis in a real-world setting.
Methods: Based on a United States oncology electronic medical record (EMR) database, patients treated with first-line platinum-based regimens after advanced NSCLC diagnosis from September 2008 to November 2014 were analyzed. Baseline characteristics and selected adverse events during treatment [incidence proportions and incidence rates (IRs)] were described by regimen. Propensity score stratification was used to adjust for baseline characteristics differences. Hazard ratios (HRs) were estimated using Cox proportional hazards model, with paclitaxel (Pac)/carboplatin (Carbo) as reference. Subgroup analysis was conducted for elderly patients (≥70 years old).
Results: The most common five regimens for the eligible patients were as follows: Pac/Carbo (n=3,009), pemetrexed (Pem)/Carbo (n=1,625), Pem/Carbo/bevacizumab (Bev) (n=735), Pac/Carbo/Bev (n=531), Pem/cisplatin (Cis) (n=357), and docetaxel (Doc)/Carbo (n=355). Highest IRs were reported for anemia, neutropenia, nausea, and vomiting across these regimens in patients of all ages. After propensity score stratification, compared with Pac/Carbo, risk of anemia was significantly lower with Pac/Carbo/Bev (HR =0.67), Pem/Cis (HR =0.68), and Pem/Carbo/Bev (HR =0.82); risk of neutropenia was comparable among all regimens except Doc/Carbo (significantly lower risk; HR =0.72); and risk of nausea (HR =1.45) and vomiting (HR =1.50) was significantly higher with Pem/Cis. Safety outcomes in elderly patients were consistent with the overall population.
Conclusions: While EMR data have limitations, the real-world safety outcome with individual chemotherapy regimen could be considered for the better selection of platinum-based therapies in NSCLC.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6940240 | PMC |
| http://dx.doi.org/10.21037/jtd.2019.11.11 | DOI Listing |
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