The Impact of Brain Metastases and Associated Neurocognitive Aspects on Health Utility Scores in EGFR Mutated and ALK Rearranged NSCLC: A Real World Evidence Analysis.


Journal

The oncologist
ISSN: 1549-490X
Titre abrégé: Oncologist
Pays: England
ID NLM: 9607837

Informations de publication

Date de publication:
07 2019
Historique:
received: 26 08 2018
accepted: 07 03 2019
pubmed: 7 4 2019
medline: 1 7 2020
entrez: 7 4 2019
Statut: ppublish

Résumé

In lung cancer, brain metastases (BM) and their treatment are associated with high economic burden and inferior health-related quality of life. In the era of targeted therapy, real world evidence through health utility scores (HUS) is critical for economic analyses. In a prospective observational cohort study (2014-2016), outpatients with stage IV lung cancer completed demographic and EQ-5D-3L surveys (to derive HUS). Health states and clinicopathologic variables were obtained from chart abstraction. Patients were categorized by the presence or absence of BM; regression analyses identified factors that were associated with HUS. A subset of patients prospectively completed neurocognitive function (NCF) tests and/or the FACT-brain (FACT-Br) questionnaire, which were then correlated with HUS (Spearman coefficients; regression analyses). Of 519 patients with 1,686 EQ-5D-3L-derived HUS, 94 (18%) completed NCF tests and 107 (21%) completed FACT-Br; 301 (58%) never developed BM, 24 (5%) developed first BM during study period, and 194 (37%) had BM at study entry. The sample was enriched (46%) for Having BM in lung cancer is not associated with inferior HUS in a population enriched for In the setting of

Sections du résumé

BACKGROUND
In lung cancer, brain metastases (BM) and their treatment are associated with high economic burden and inferior health-related quality of life. In the era of targeted therapy, real world evidence through health utility scores (HUS) is critical for economic analyses.
MATERIALS AND METHODS
In a prospective observational cohort study (2014-2016), outpatients with stage IV lung cancer completed demographic and EQ-5D-3L surveys (to derive HUS). Health states and clinicopathologic variables were obtained from chart abstraction. Patients were categorized by the presence or absence of BM; regression analyses identified factors that were associated with HUS. A subset of patients prospectively completed neurocognitive function (NCF) tests and/or the FACT-brain (FACT-Br) questionnaire, which were then correlated with HUS (Spearman coefficients; regression analyses).
RESULTS
Of 519 patients with 1,686 EQ-5D-3L-derived HUS, 94 (18%) completed NCF tests and 107 (21%) completed FACT-Br; 301 (58%) never developed BM, 24 (5%) developed first BM during study period, and 194 (37%) had BM at study entry. The sample was enriched (46%) for
CONCLUSION
Having BM in lung cancer is not associated with inferior HUS in a population enriched for
IMPLICATIONS FOR PRACTICE
In the setting of

Identifiants

pubmed: 30952820
pii: theoncologist.2018-0544
doi: 10.1634/theoncologist.2018-0544
pmc: PMC6656458
doi:

Substances chimiques

EGFR protein, human EC 2.7.10.1
ErbB Receptors EC 2.7.10.1

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e501-e509

Informations de copyright

© AlphaMed Press 2019.

Déclaration de conflit d'intérêts

Disclosures of potential conflicts of interest may be found at the end of this article.

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Auteurs

Grainne M O'Kane (GM)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

Jie Su (J)

Ontario Cancer Institute Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

Brandon C Tse (BC)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

Vivian Tam (V)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

Tiffany Tse (T)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

Lin Lu (L)

Ontario Cancer Institute Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

Michael Borean (M)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

Emily Tam (E)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

Catherine Labbé (C)

Centre de recherce de l'Institute universitarie de cardiologie et de pneumonologie de Quebec, University of Laval, Sherbrooke, Quebec, Canada.

Hiten Naik (H)

Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Nicole Mittmann (N)

Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Mark K Doherty (MK)

Medical Oncology and Hematology Division, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Penelope A Bradbury (PA)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

Natasha B Leighl (NB)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

Frances A Shepherd (FA)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

Nadine M Richard (NM)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

Kim Edelstein (K)

Gerry and Nancy Pencer Brain Tumor Centre, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

David Shultz (D)

Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

M Catherine Brown (MC)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

Wei Xu (W)

Ontario Cancer Institute Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

Doris Howell (D)

Princess Margaret Cancer Centre Research Institute, Toronto, Ontario, Canada geoffrey.liu@uhn.on.ca doris.howell@uhn.ca.

Geoffrey Liu (G)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada geoffrey.liu@uhn.on.ca doris.howell@uhn.ca.

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