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1303P COST EFFECTIVENESS OF PEMETREXED/CISPLATIN (PEM/
CIS) IN THE TREATMENT OF ADVANCED, NON-SQUAMOUS,
NON-SMALL CELL LUNG CANCER (NSQNSCLC) PATIENTS
K.B. Winfree 1 , M. Shah 2 , P. Peterson 3 , S. Gruschkus 2 , M. Eaddy 2 , M. Green 2
1 Global Health Outcomes Oncology, Eli Lilly and Company, Indianapolis, UNITED
STATES OF AMERICA, 2 Oncology, Xcenda AmerisourceBergen Consulting
Services, Palm Harbor, FL, UNITED STATES OF AMERICA, 3 Oncology Statistics,
Eli Lilly and Company, Indianapolis, IN, UNITED STATES OF AMERICA
Purpose: Pem/cis is indicated for 1 st line therapy in patients (pts) with advanced,
nsqNSCLC. Data from community practices provide an opportunity to evaluate the
cost effectiveness (CE) of Pem/cis relative to other 1 st line regimens.
Methods: Advanced nsqNSCLC pts receiving 1 st line therapy with Pem/cis,
carboplatin/paclitaxel + bevacizumab (C/P + B), or carboplatin/paclitaxel (C/P) from
2006–2009 were identified through EMRs of 20 large US community oncology
practices. Pts were matched by stage, ECOG performance status (PS), gender, age,
and index year. Progression-free survival (PFS)/overall survival (OS) were calculated
and treatment effect was assessed via Kaplan-Meier and Cox regression analyses.
Costs included chemotherapy, supportive care, and medical services. To evaluate CE,
differences in costs/survival were calculated. Bootstrapping was used to estimate 95%
confidence intervals (CIs) for mean differences and probability of falling within
quadrants of CE plane.
Results: Each comparison had 78 matched pairs. Mean age was 64.1, 59.0% were
male and 78.2% had PS = 0/1. Median PFS for pts treated with Pem/cis (128 days)
was significantly longer than those treated with C/P + B (112 days; P = 0.007) or C/P
(105 days; P = 0.004). Pts treated with Pem/cis had higher median OS, however not
significant. Analyses of costs/PFS and costs/OS revealed greater effectiveness with less
cost for Pem/cis compared to C/P + B (Tables).
Conclusions: Pts treated with Pem/cis experienced a significant PFS benefit and a
trending OS benefit compared to C/P + B and C/P pts. Compared to C/P + B, Pem/
cis yielded greater effectiveness with less cost.
Pem/cis vs C/P + B Pem/cis vs C/P
Mean D OS (95% CI) 30 days (-44.0, 98.6) 57 days (-8.4, 134.6)
Mean D Cost (95% CI)
Probability Pem/cis is
-$18,216 (-$33,306, -$3,889) $25,111 ($9,987, $30,627)
less costly, more effective 83.7% 0%
more costly, more
effective
1.0% 95.8%
Pem/cis vs C/P + B Pem/cis vs C/P
Mean D PFS (95% CI) 15 days (-53.3, 82.3) 39 days (-23.5, 99.7)
Mean D Cost (95% CI)
Probability Pem/cis is
-$17,603 (-$27,547, -$2,817 ) $25,583 ($15,601, $38,741)
less costly, more effective 63.4% 0%
more costly, more
effective
1.2% 89.4%
Disclosure: K.B. Winfree: I am an employee of and have stock ownership in Eli
Lilly and Company. M. Shah: Eli Lilly and Company sponsored this research
study. P. Peterson: I am an employee of and have stock ownership in Eli Lilly and
Company. S. Gruschkus: Eli Lilly and Company sposored this research study. M.
Eaddy: Eli Lilly and Company sposored this research study. M. Green: On 3/16/12
I served as moderator for a Lilly Global Adv Board per my employment with
Xcenda. Consistent with Lilly rules, the payments made to Xcenda for services
will appear on the Lilly website delineating payments to physicians for services to
Lilly.
Annals of Oncology
1304P CHARACTERISTICS OF 982 LUNG CANCER PATIENTS IN
SERBIA ACCORDING TO THE WHO/IASLC CLASSIFICATION
OF LUNG CANCERS AND SUBSEQUENT TREATMENT –
AVATAR EPIDEMIOLOGY STUDY
D. Jovanovic 1 , N. Secen 2 , Z. Murtezani 3 , M. Rancic 4 , V. Kacar-Kukric 1 ,
M. Velinovic 1 , A. Tepavac 5 , E. Budisin 5 , Z.G. Andric 3 , N. Vukobradovic Djoric 6
1 Institute of Lung Diseases, Clinical Center of Serbia, Belgrade, SERBIA, 2 Clinic
for Pulmonary Oncology - Department for Chemotherapy, Institute for Pulmonary
Diseases of Vojvodina, Sremska Kamenica, SERBIA, 3 Medical Oncology, KBC
Bezanijska Kosa, Belgrade, SERBIA, 4 Clinic for Pulmonary Diseases - Knez Selo,
Clinical Center Nis, Nis, SERBIA, 5 Clinic for Pulmonary Oncology, Institute for
Pulmonary Diseases of Vojvodina, Sremska Kamenica, SERBIA, 6 Medical,
Roche, Belgrade, SERBIA
Introduction/background: The purpose of this prospective study, conducted over 3
months period, was to analyse demographic and clinicopathological features of lung
cancer patients in Serbia, and subsequent treatment approach as well.
Material and methods: The data on lung cancer patients were collected based on
specific questionnaire at 4 major centers in Serbia. An analysis of demographic and
clinical/ histological features with subsequent treatment was performed in 982
patients (aged over 19 years).
Results: Male to female ratio 709 (72%): 273 (28%), 46% aged < 60 years. Majority
were current smokers (68%) and ex-smokers (21%), 11% non-smokers. NSCLC was
diagnosed in 80% (789), and SCLC in 19 %. Among NSCLC patients, 71.6 % had
stage IIIb and IV. Most common histological subtype was adenocarcinoma (46%),
squamous cell carcinoma - 44%, large cell - 4% and the rest NOS and rare subtypes.
Neodjuvant therapy was applied in 8%, 19% were operated: 64% of them recieved
adjuvant chemotherapy. Most common adjuvant regimens were PE (65%) and
platinum/gemcitabine (20%). First line chemotherapy was applied in 91% of stage
IIIb and IV NSCLC patients: platinum/etoposide-51% and platinum/
gemcitabine-45% were most frequently applied. ECOG PS 0 and 1, was noted in
92%. Second line chemotherapy was given to 27% of patients who recieved 1st line
therapy. Most common 2nd line regimens were platinum/gemcitabine (35%),
platinum/taxanes (18%), platinum/vinorelbine (13%) and taxanes monotherapy
(12.5%). Only 8% recieved pemetrexed or erlotinib. Almost all 2nd line treated
patients (93%) had good ECOG PS: 0 and 1. Third line chemotherapy was applied in
22% of those who recieved 2nd line.
Conclusions: This is the largest series of lung cancer patients in Serbia, analized by
both, patient characteristics and therapy regimens. Compared with previous similar
analysis from 2009, it can be concluded the number of NSCLC patients is increasing,
especially in stage IIIb and IV (1.5% per year). Adenocarcinoma rate is also
increasing (41% in 2009 vs 45% in 2011). Regarding treatment, we can conclude
there is no major progress in treatment options in Serbia.
Disclosure: All authors have declared no conflicts of interest.
1305P FACTORS PREDICTING BRAIN METASTASES IN PATIENTS
WITH NON-SMALL CELL LUNG CANCER
S. Hsiao 1 , C. Chung 1 , H.E. Liu 2
1 Division of Pulmonary Medicine, Department of Internal Medicine, Taipei
Medical University Hospital, Taipei, Taipei, TAIWAN, 2 Division of Hematolgy and
Oncology, Department of Internal Medicine, Department of Medicine, Wanfang
Hospital, Taipei Medical University, Taipei, TAIWAN
Purpose: Brain metastases (BM), a common complication of non-small cell lung cancer
(NSCLC), usually lead to a poor prognosis. Recent advances in BM therapy modesly
prolong the survival after BM diagnosis in a subset of patients. Selection of treatment
modalities for BM is based largely on the number of BM, BM-related symptoms and
patient’s functional performance status. Therfore, early dection of BM in high-risk
patients is crucial. In this study, we sough to elucidate the factors predicting BM.
Methods and patients: Medical records of patients with stage 1-4 NSCLC were
retrospectively reviewed for the period between January 2006 and December 2011
under the approval of the joint institutional review board. Clinical demographic data,
ix428 | Abstracts Volume 23 | Supplement 9 | September 2012