title: Use of pemetrexed for non-small cell lung cancer in the Andalusian public health system.
abstract: The aim of this study is to determine the profile of the use of pemetrexed in metastatic or locally advanced NSCLC in Andalusia and its variation over 2 years (2010-2011). A prescription-indication observational retrospective multicenter study was conducted. Adult patients with locally advanced/metastatic NSCLC who received pemetrexed in any hospital in the Andalusian Public Health System during the first term of 2010 or the last term of 2011 were included. We collected patients' baseline characteristics, tumour histology and stage, pemetrexed indication and performance status at the start of treatment. In all, 107 and 170 patients (62 ± 11 years old) from 17 hospitals were included in 2010 and 2011, respectively. The predominant histology was adenocarcinoma (85%), 88% of patients had stage IV tumours and 52% Eastern Cooperative Oncology Group stage (ECOG) 1. Pemetrexed indications in 2010 and 2011 were: First line combined with platinum (28.97-37.64%); first line combined with platinum and maintenance with pemetrexed (24.30-28.82%); second line mono-therapy (12.15-7.65%) and maintenance (2.15-7.05%). Off-label use was detected in 22.43% (2010) and 18.84% (2011). In conclusion, pemetrexed combined with platinum is mainly used as first-line treatment in NSCLC patients with stage IV, adenocarcinoma histologic subtype and good performance status. Off-label use is high (especially in 2010). An adequate therapeutic positioning for pemetrexed based on effectiveness and safety analysis should be defined, so that NSCLC patients could be beneficiated with the most cost-effective chemotherapy treatment.
authors.affiliation: Pharmacy Department, Hospital Universitario Virgen del Rocío , Seville, Spain.
authors.forename: María Antonia
authors.initials: MA
authors.lastname: Pérez-Moreno
authors.forename: Jesús
authors.initials: J
authors.lastname: Cotrina-Luque
authors.forename: Mercedes
authors.initials: M
authors.lastname: Galván-Banqueri
authors.forename: Sandra
authors.initials: S
authors.lastname: Flores-Moreno
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Bautista-Paloma
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Calleja-Hernández
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000627:therapeutic use; D018672:Community Health Planning; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D056687:Off-Label Use; D000068437:Pemetrexed / Q000627:therapeutic use*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D000068437:Pemetrexed; D002945:Cisplatin
keywords: Drug utilisation study; Non-small-cell lung cancer; Pemetrexed; Utilisation evaluation