A burden-of-illness study in patients with stage IB-IIIA non-small cell lung cancer in France, Germany, and the UK
Danson, S., Andreas, S., Chouaid, C., Siakpere, O., Benjamin, L., Ehness, R., Dramard-Goasdoue, M., Barth, J., Price, M., Wolowacz, S., Kaye, J., & Kontoudis, I. (2014). Lucabis: A burden-of-illness study in patients with stage IB-IIIA non-small cell lung cancer in France, Germany, and the UK. Annals of Oncology, 25(Suppl 4), iv415-iv416. http://annonc.oxfordjournals.org/content/25/suppl_4/iv415.3.abstract?sid=a6aef93f-2c3a-41de-a7de-64e0596e6489
Aim: Although new adjuvant treatments (ADJ) are being developed for patients (pts) with resected non-small cell lung cancer (NSCLC), the health technology assessment, they will be subject to in many countries, can be limited by the scarcity of real-world data in the specific disease setting. This study aimed to collect such data in France (F), Germany (G), and the United Kingdom (UK) looking at characteristics of pts receiving ADJ (or not), clinical outcomes, resource utilization and costs.
Methods: Pts were age ?18 years (yrs) with completely resected stage IB-IIIA NSCLC diagnosed from August 2009 to July 2012. Pts were enrolled at clinical sites by a systematic sampling method. Pts could be living or deceased at the time of data collection. Clinical info was abstracted from medical records. All analyses were descriptive.
Results: Data on 831 pts (F: 251; G: 287; UK: 293) were collected through 39 (F: 14; G: 11; UK: 14). Thirty-three percent were age ?60 yrs, 37% were 61-70 yrs, and 30% were ?71 yrs; 62% were male. Histology was adenocarcinoma (53%), squamous (38%), large cell (2%), or unspecified (6%). Seventy-two percent had systematic lymph node dissection (F: 96%; G: 90%; UK: 33%). Stages were IB (29%), IIA (22%), IIB (20%), and IIIA (30%). More pts had stages IB or IIA in UK (66%) than in F (39%) or G (44%). Overall, 402 pts (48%) received ADJ (F: 62%; G: 52%; UK: 33%). Cisplatin + vinorelbine ADJ was used most frequently (258 pts; 64% of those given ADJ). Common reasons for not using ADJ were: pt declined (13%), comorbidities (12%), surgery complication (8%), or poor performance status (7%).. Median overall survival (OS) was not reached while 25th percentile was 31.2 months (mth) (95%; CI 26.8-36.0 mth). Median disease-free survival (DFS) was 48.0 mth (95%; CI 42.3 mth-not estimable).
Conclusions: ADJ use increased by stage but was used in less than half of pts overall and was used less in the UK than in F or G. It may be possible that a favorable stage distribution in UK is related to less use of systematic lymph node dissection.