title: Treatment Patterns and Health Resource Utilization Among Patients Diagnosed With Early Stage Resected Non-Small Cell Lung Cancer at US Community Oncology Practices.
abstract: Data on adjuvant therapy in resected non-small cell lung cancer (NSCLC) in routine practice are lacking in the United States. This retrospective observational database study included 609 community oncology patients with resected stage IB to IIIA NSCLC. Use of adjuvant therapy was 39.1% at disease stage IB and 64.9% to 68.2% at stage II to IIIA. The most common regimen at all stages was carboplatin and paclitaxel.
  
  
  BACKGROUND
  Platin-based adjuvant chemotherapy has extended survival in clinical trials in patients with completely resected non-small cell lung cancer (NSCLC). There are few data on the use of adjuvant therapy in community-based clinical practice in the United States.
  
  
  METHODS
  This was a retrospective observational study using electronic medical record and billing data collected during routine care at US community oncology sites in the Vector Oncology Data Warehouse between January 2007 and January 2014. Patients aged ≥ 18 years with a primary diagnosis of stage IB to IIIA NSCLC were eligible if they had undergone surgical resection. Treatment patterns, health care resource use, and cost were recorded, stratified by stage at diagnosis.
  
  
  RESULTS
  The study included 609 patients (mean age, 64.8 years, 52.9% male), of whom 215 had stage IB disease, 130 stage IIA/II, 110 stage IIB, and 154 stage IIIA. Adjuvant systemic therapy after resection was provided to 345 (56.7%) of 609 patients, with lower use in patients with stage IB disease (39.1%) than stage II to IIIA disease (64.9-68.2%) (P < .0001). The most common adjuvant regimen at all stages was the combination of carboplatin and paclitaxel. There were no statistically significant differences in office visits or incidence of hospitalization by disease stage. During adjuvant treatment, the total monthly median cost per patient was $17,389.75 (interquartile range, $8,815.61 to $23,360.85).
  
  
  CONCLUSIONS
  Adjuvant systemic therapy was used in some patients with stage IB NSCLC and in the majority of patients with stage IIA to IIIA disease. There were few differences in regimen or health care resource use by disease stage.
authors: GSK, Philadelphia, PA. Electronic address: philip.o.buck@gsk.com.
authors: Philip O
authors: PO
authors: Buck
authors: Vector Oncology Solutions, Memphis, TN.
authors: Kimberly R
authors: KR
authors: Saverno
authors: Vector Oncology Solutions, Memphis, TN.
authors: Paul J E
authors: PJ
authors: Miller
authors: GSK, Philadelphia, PA.
authors: Bhakti
authors: B
authors: Arondekar
authors: Vector Oncology Solutions, Memphis, TN.
authors: Mark S
authors: MS
authors: Walker
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000191:economics; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003151:Community Health Centers; D003365:Costs and Cost Analysis; D057286:Electronic Health Records; D006295:Health Resources; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D011013:Pneumonectomy; D040841:Resource Allocation; D012189:Retrospective Studies; D014481:United States
chemical_list: D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin
keywords: Adjuvant chemotherapy; Electronic medical records; Health care costs; Retrospective database