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H. Chen
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P2.03 - Chemotherapy/Targeted Therapy (ID 704)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 2
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.03-003 - Cost Effectiveness of Gefitinib for Lung Adenocarcinoma Patients with Mutant Epidermal Growth Factor Receptor (ID 7382)
09:30 - 09:30 | Author(s): H. Chen
- Abstract
Background:
Tyrosine kinase inhibitor such as Gefitinib rather than conventional chemotherapy is the standard of care for advanced lung adenocarcinoma (LA) with mutant epidermal growth factor receptor (mEGFR). However, its cost-effectiveness is less clear. The aim of our study is to compare the cost and effectiveness of 1[st] line gefitinib vs platinum-based chemotherapy for clinical stage IV LA via this population-based propensity score (PS) matched analysis.
Method:
We identified eligible patients diagnosed within 2011 through a comprehensive population-based database containing cancer and death registries, and reimbursement data in Taiwan. The primary duration of interest (DOI) was two years within diagnosis. Effectiveness was measured as survival whereas direct medical cost was measured from the health care sector’s perspective. In supplementary analysis (SA), we estimated the cost-effectiveness under potential unmeasured confounder(s) and the cost-effectiveness if the DOI was three years.
Result:
Our study population constituted 240 patients [Table 1]. Within 2 years, gefitinib was both more effective [mean overall survival 1.48 vs 1.47 life-year] and cost-saving [mean 78770 vs 82684, 2015 US dollars] when compared to chemotherapy. In SA, our results was sensitive to potential unmeasured confounder(s) but remained cost-effective when DOI was 3 years.Table 1. Patient characteristics of the propensity-score matched final study population
Gefitinib Platinum-based chemotherapy standardized difference (rounded) number (%) number (%) age <65 76 (63.33) 75 (62.5) 0.017 >=65 44 (36.67) 45 (37.5) gender female 60 (50) 60 (50) 0 male 60 (50) 60 (50) residency non-north 55 (45.83) 56 (46.67) 0.017 north 65 (54.17) 64 (53.33) comorbidity without 62 (51.67) 64 (53.33) 0.033 with 58 (48.33) 56 (46.67) smoking history no 79 (65.83) 79 (65.83) 0 yes 41 (34.17) 41 (34.17) performance status 0-1 113 (94.17) 113 (94.17) 0 2 7 (5.83) 7 (5.83)
Conclusion:
1[st] line gefitinib was cost-effective for clinically stage IV LA with mEGFR from health care sector’s perspective when compared to platinum-based chemotherapy.
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P2.03-038 - Early Serum Tumor Markers After 14 Days of Tyrosine Kinase Inhibitor Target Therapy Predicts Outcomes in Patients with Lung Adenocarcinoma (ID 9432)
09:30 - 09:30 | Author(s): H. Chen
- Abstract
Background:
The aim of the study was to demonstrate whether early variations in the levels of serum 4 tumor markers (TMs), carcinoembryonic antigen [CEA], cancer antigen [CA]125, CA19-9, and CA15-3), after TKI target therapy were associated with treatment response and progression-free survival (PFS) in patients with lung adenocarcinoma.
Method:
Patients with stage IIIB-IV lung adenocarcinoma taking epidermal growth factor receptor (EGFR) TKIs or anaplastic lymphoma kinase (ALK) inhibitors were enrolled prospectively from June 2012 to February 2015. According to the variations of percentage of change in 4-TM levels (4-TM~pc~), we divided patients into ascending (increases in 4-TM~pc~ over the 7[th]- 14[th ]day) and descending (decreases in 4-TM~pc~ over the 7[th]- 14[th ]day) groups.
Result:
In all, 184 patients were enrolled, and 89% had at least one of the pre-treatment evaluable TMs and were further analyzed. A good response to the TKI target therapy was accurately predicted in the descending group, as determined using receiver operating characteristic curve analysis (an area under the curve, 0.83). The kappa value between type of 4-TM~pc~ and measurable radiographic lesions was 0.762. Multivariate Cox hazards model analyses demonstrated that the type of 4-TM~pc~ and mutation status were the strongest predictors of PFS (descending versus ascending, hazard ratios [HR] 0.30, 95% confidence interval [CI], 0.19–0.47; sensitive mutation versus wide type, HR 0.30, 95% CI, 0.19–0.48).
Conclusion:
Type of 4-TM~pc~ 14 days after TKI target therapy is associated with an image response and PFS, without regarding mutation status, in patients with advanced lung adenocarcinoma.
