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Molecular testing and treatment patterns for patients with advanced non-small cell lung cancer: PIvOTAL observational study.
Lee, Dae Ho; Tsao, Ming-Sound; Kambartel, Karl-Otto; Isobe, Hiroshi; Huang, Ming-Shyan; Barrios, Carlos H; Khattak, Adnan; de Marinis, Filippo; Kothari, Smita; Arunachalam, Ashwini; Cao, Xiting; Burke, Thomas; Valladares, Amparo; de Castro, Javier.
Afiliación
  • Lee DH; Asan Medical Center, Seoul, Republic of Korea.
  • Tsao MS; University Health Network, Princess Margaret Cancer Centre, Toronto, Canada.
  • Kambartel KO; Krankenhaus Bethanien, Moers, Germany.
  • Isobe H; KKR Sapporo Medical Center, Sapporo-shi, Hokkaido, Japan.
  • Huang MS; Kaohsiung Medical University Hospital, College of Medicine, Kaohsiung Medical University, Taiwan.
  • Barrios CH; Hospital do Câncer Mãe de Deus, Porto Alegre, Brazil.
  • Khattak A; Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
  • de Marinis F; European Institute of Oncology, IRCCS, Milan, Italy.
  • Kothari S; Center for Observational and Real World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ, United States of America.
  • Arunachalam A; Center for Observational and Real World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ, United States of America.
  • Cao X; Center for Observational and Real World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ, United States of America.
  • Burke T; Center for Observational and Real World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ, United States of America.
  • Valladares A; Outcomes Research, Merck Sharp & Dohme de España, Madrid, Spain.
  • de Castro J; Hospital Universitario La Paz (IDIPAZ), Madrid, Spain.
PLoS One ; 13(8): e0202865, 2018.
Article en En | MEDLINE | ID: mdl-30148862
ABSTRACT

BACKGROUND:

The goals of this multinational retrospective study were to describe treatment patterns and survival outcomes by receipt of molecular testing and molecular status of patients with advanced non-small cell lung cancer (NSCLC).

METHODS:

This chart review study, conducted in Italy, Spain, Germany, Australia, Japan, Korea, Taiwan, and Brazil, included 1440 patients with newly diagnosed advanced (stage IIIB/IV) NSCLC initiating systemic therapy from January 2011 through June 2013, with follow-up until July 2016. We evaluated treatment patterns and survival by histology, line of therapy, molecular testing, and test results for epidermal growth factor receptor (EGFR) mutation and/or anaplastic lymphoma kinase (ALK) rearrangement. Country-specific data were analyzed descriptively and presented as ranges (lowest to highest country). Overall survival (OS) was estimated using Kaplan-Meier method.

RESULTS:

Patients with ≥1 molecular test varied from 43% (Brazil) to 85% (Taiwan). Numerically greater proportions of patients who were female, Asian, or never/former-smokers, and those with nonsquamous histology or stage-IV NSCLC, received a test. Testing was common for nonsquamous NSCLC (54%, Brazil, to 91%, Taiwan), with positive EGFR and ALK tests from 17% (Brazil and Spain) to 67% (Taiwan) and from 0% (Brazil) to 60% (Taiwan), respectively. First-line treatment regimens for nonsquamous NSCLC with positive EGFR/ALK tests included targeted therapy for 30% (Germany) to 89% (Japan); with negative/inconclusive test results, platinum-based combinations for 88% (Japan) to 98% (Brazil); and if not tested, platinum-based combinations for 80% (Australia) to 95% (Japan), except in Taiwan, where 44% received single agents. Median OS from first-line therapy initiation was 10.0 (Japan) to 26.7 (Taiwan) months for those tested and 7.6 (Australia/Brazil) to 19.3 (Taiwan) months for those not tested.

CONCLUSIONS:

We observed substantial variation among countries in testing percentages, treatment patterns, and survival outcomes. Efforts to optimize molecular testing rates should be implemented in the context of each country's health care scenario.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Carcinoma de Células Escamosas / Protocolos de Quimioterapia Combinada Antineoplásica / Biomarcadores de Tumor / Carcinoma de Pulmón de Células no Pequeñas / Neoplasias Pulmonares Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Asia / Brasil / Europa / Oceania Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2018 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Carcinoma de Células Escamosas / Protocolos de Quimioterapia Combinada Antineoplásica / Biomarcadores de Tumor / Carcinoma de Pulmón de Células no Pequeñas / Neoplasias Pulmonares Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Asia / Brasil / Europa / Oceania Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2018 Tipo del documento: Article