The online version of this article (https://doi.org/10.1186/s12885-018-4032-3) contains supplementary material, which is available to authorized users.
We evaluated treatment decisions and outcomes in a cohort of predominately Caucasian patients with EGFR mutation-positive (EGFR Mut+) non-small-cell lung cancer (NSCLC).
REASON (NCT00997230) was a non-interventional study in German patients with stage IIIB/IV NSCLC. Secondary endpoints for EGFR Mut + NSCLC included progression-free survival (PFS), overall survival (OS), adverse event (AE) management, and pharmacoeconomic outcomes.
Among 334 patients with EGFR Mut + NSCLC, tyrosine kinase inhibitors (TKIs) were the most common first-line therapy (56.6%, 53.0% gefitinib). Among patients who received TKIs/gefitinib before first disease progression, PFS was longer compared with those who did not receive a TKI (median 10.1/10.0 vs. 7.0 months; HR 0.67/0.69; log-rank p = 0.012/p = 0.022). OS was longer for those patients who ever received a TKI/gefitinib during their complete therapy course compared with those who never received a TKI (median 18.4/18.1 vs. 13.6 months; HR 0.53/0.55; p = 0.003/p = 0.005). Total mean first-line treatment healthcare costs per person were higher for those receiving TKIs (€46,443) compared with those who received chemotherapy (€27,182). Mean outpatient and inpatient costs were highest with chemotherapy. Rash, diarrhea, and dry skin were the most commonly reported AEs for patients receiving gefitinib.
In REASON, TKI therapy was the most common first- and second-line treatment for EGFR Mut + NSCLC, associated with increased drug costs compared with chemotherapy. Patients who received gefitinib or a TKI ever during their complete therapy course had prolonged PFS and OS compared with patients who did not receive a TKI.
The trial was registered on October, 2009 with ClinicalTrials.gov: https://clinicaltrials.gov/ct2/show/NCT00997230?term=NCT00997230&rank=1
Additional file 1: Table S1. Treatment costs according to type of first-line treatment received by patients with EGFR Mut + NSCLC. (DOCX 15 kb)12885_2018_4032_MOESM1_ESM.docx
German Cancer Guidelines. Lungenkarzinom, nicht-kleinzellig (NSCLC). Onkopedia 2016. https://www.onkopedia.com/de/onkopedia/guidelines/lungenkarzinom-nicht-kleinzellig-nsclc/@@view/html/index.html. Accessed 1 Apr 2016.
Schuette W, Schirmacher P, Eberhardt WE, et al. EGFR mutation status and first-line treatment in patients with stage III/IV non-small cell lung cancer in Germany: an observational study. Cancer Epidemiol Biomark Prev. 2015;24:1254–61. CrossRef
Kris MG, Johnson B, Berry L, et al. Treatment with therapies matched to oncogenic drivers improves survival in patients with lung cancers: results from the lung cancer mutation consortium (LCMC). Sydney, Australia: Presented at the WCLC, 2013. Abstract PL03.07. p. 27–31. http://pic1.cmt.com.cn/newspic/files/%E4%BC%9A%E8%AE%AE%E6%97%A5%E7%A8%8B.pdf. Accessed 29 Jan 2018.
Clinical Lung Cancer Genome Project (CLCGP), Network Genomic Medicine (NGM). A genomics-based classification of human lung tumors. Sci Transl Med. 2013;5(209):ra153.
Knetki-Wroblewska M, Kowalski DM, Zajda K, et al. Gefitinib in patients with advanced non-small-cell lung cancer. Pneumonol Alergol Pol. 2012;80:439–49. PubMed
Souquet P-J, Fournel P, Locher C, et al. MUTACT: an observational study of EGFR mutation status and management of patients with non-small cell lung cancer (NSCLC) adenocarcinoma. Ann Oncol. 2012;23(Suppl 9):ix400–46. (Abstract 1270P)
AstraZeneca. IRESSA (Gefitinib) receives marketing authorisation for the treatment of non-small cell lung cancer in Europe [press release]. AstraZeneca UK Ltd. 2009. https://www.astrazeneca.com/media-centre/press-releases/2009/IRESSA-Gefitinib-Receives-Marketing-Authorisation-01072009.html##. Accessed 1 Apr 2016.
Roche. Roche's Tarceva receives European approval for first-line use in a genetically distinct type of lung cancer [press release]. F. Hoffmann-La Roche Ltd. 2011. https://www.roche.com/media/store/releases/med-cor-2011-09-01.htm. Accessed 1 Apr 2016.
Eberhardt W, Thomas M, Graf von der Schulenberg J-M, et al. EGFR mutation testing and first-line treatment of patients with advanced NSCLC and positive EGFR mutation status: results from a German registry. Eur J Cancer. 2011;47:S636. CrossRef
- Treatment decisions, clinical outcomes, and pharmacoeconomics in the treatment of patients with EGFR mutated stage III/IV NSCLC in Germany: an observational study
Wilfried E. E. Eberhardt
- BioMed Central
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