Comparative Effectiveness and Resource Utilization in Patients Receiving First-Line Taxane-Based Chemotherapy for Stage IV Non-Small Cell Lung Cancer in a US Community Oncology Setting

• Published in: Clinical lung cancer 2016
• Main Authors: Weiss, Jared, Force, Rex W, Pugmire, Brook A, Peterson, Teri, Faria, Claudio, Margunato-Debay, Sandra, Patel, Manish B
• Format: Article
• Language: English
• Subjects: Hematology, Oncology and Palliative Medicine; Pulmonary/Respiratory
• ISSN: 1525-7304
• DOI: 10.1016/j.cllc.2016.12.008

Abstract Background Weekly (qw) nab -paclitaxel ( nab -P) was approved for advanced NSCLC based on a phase III trial where nab -P/carboplatin demonstrated a significantly higher response rate than every-3-weeks (q3w) paclitaxel (P)/carboplatin. Little information exists on relative real-world results. Methods This retrospective study used data from a national electronic medical record database. Patients receiving first-line nab -P qw, P qw, or P q3w for stage IV NSCLC were identified. Total cumulative dose, time to treatment discontinuation (TTD), and database persistence (a proxy measure for survival) were analyzed for all patients and in squamous and elderly subgroups. Results A total of 114, 208, and 153 patients received nab -P qw, P qw, and P q3w, respectively. Median age was 72, 69, and 67 years, respectively; 56%, 48%, and 37% were ≥ 70 years and 75%, 43%, and 23% had squamous histology. Total cumulative dose was significantly greater with nab -P qw. TTD was longer with nab -P qw vs P qw (HR, 0.54 [95% CI, 0.40-0.72]; P < .001) and vs P q3w (HR, 0.53 [95% CI, 0.38-0.73]; P < .001). Database persistence was longer with nab -P qw vs P qw (HR, 0.56 [95% CI, 0.39-0.79]; P = .001) and vs P q3w (HR, 0.52 [95% CI, 0.34-0.78]; P = .002). TTD after experiencing any hematologic adverse event was longer with nab -P qw. Findings were consistent across subgroup analyses. Conclusion In a real-world setting, nab -P qw was associated with a significantly greater cumulative dose and significantly longer TTD and database persistence compared with P qw and P q3w.