title: Comparative Effectiveness and Resource Usage in Patients Receiving First-line Taxane-based Chemotherapy for Stage IV Non-Small-cell Lung Cancer in a US Community Oncology Setting.
abstract: Weekly (qw) nanoparticle albumin-bound (nab)-paclitaxel was approved for advanced non-small-cell lung cancer based on the results from a phase III trial in which nab-paclitaxel/carboplatin demonstrated a significantly greater response rate compared with paclitaxel/carboplatin every 3 weeks (q3w). Little information exists on relative real-world results.
  
  
  
  The present retrospective study used data from a national electronic medical record database. Patients receiving first-line nab-paclitaxel qw, paclitaxel qw, or paclitaxel q3w for stage IV non-small-cell lung cancer (NSCLC) were identified. The total cumulative dose, time to treatment discontinuation (TTD), and database persistence (a proxy measure for survival) were analyzed for all patients and for the squamous and elderly subgroups.
  
  
  
  A total of 114, 208, and 153 patients received nab-paclitaxel qw, paclitaxel qw, and paclitaxel q3w, respectively. In the corresponding treatment arms, the median age was 72, 69, and 67 years; 56%, 48%, and 37% were aged ≥ 70 years; and 75%, 43%, and 23% had squamous cell NSCLC. The total cumulative dose was significantly greater with nab-paclitaxel qw. The TTD was longer with nab-paclitaxel qw than with paclitaxel qw (hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.40-0.72; P < .001) or with paclitaxel q3w (HR, 0.53; 95% CI, 0.38-0.73; P < .001). Database persistence was longer with nab-paclitaxel qw than with paclitaxel qw (HR, 0.56; 95% CI, 0.39-0.79; P = .001) or with paclitaxel q3w (HR, 0.52; 95% CI, 0.34-0.78; P = .002). The TTD after experiencing any hematologic adverse event was longer with nab-paclitaxel qw. The findings were consistent across the subgroup analyses.
  
  
  
  In a real-world setting, nab-paclitaxel qw was associated with a significantly greater cumulative dose and significantly longer TTD and database persistence compared with paclitaxel qw and paclitaxel q3w.
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: jared_weiss@med.unc.edu.
authors.forename: Jared
authors.initials: J
authors.lastname: Weiss
authors.affiliation: improveRx, Pocatello, ID.
authors.forename: Rex W
authors.initials: RW
authors.lastname: Force
authors.affiliation: improveRx, Pocatello, ID.
authors.forename: Brook A
authors.initials: BA
authors.lastname: Pugmire
authors.affiliation: improveRx, Pocatello, ID.
authors.forename: Teri
authors.initials: T
authors.lastname: Peterson
authors.affiliation: Celgene Corporation, Summit, NJ.
authors.forename: Claudio
authors.initials: C
authors.lastname: Faria
authors.affiliation: Celgene Corporation, Summit, NJ.
authors.forename: Sandra
authors.initials: S
authors.lastname: Margunato-Debay
authors.affiliation: Celgene Corporation, Summit, NJ.
authors.forename: Manish B
authors.initials: MB
authors.lastname: Patel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001952:Bridged-Ring Compounds / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D019058:Community Networks; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D053758:Nanoparticles; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000627:therapeutic use*; D012189:Retrospective Studies; D016019:Survival Analysis; D043823:Taxoids / Q000627:therapeutic use*; D014481:United States; D028761:Withholding Treatment
chemical_list: D001952:Bridged-Ring Compounds; D043823:Taxoids; C080625:taxane; D016190:Carboplatin; D017239:Paclitaxel
keywords: Elderly; Retrospective; Squamous; Treatment duration; nab-Paclitaxel