1101P - Healthcare resource utilization (HCRU) in patients receiving ipilimumab for advanced melanoma: Impact of survival and Eastern Cooperative Oncology...
| Date | 28 September 2014 |
| Event | ESMO 2014 |
| Session | Poster Display session |
| Topics | Bioethics, Legal, and Economic Issues Cancer Immunology and Immunotherapy Melanoma and other Skin Tumours |
| Presenter | Ahmad Tarhini |
| Citation | Annals of Oncology (2014) 25 (suppl_4): iv374-iv393. 10.1093/annonc/mdu344 |
| Authors |
A. Tarhini1, A.S. Rao2, S. Corman3, M. Botteman3, S. Mehta3, X. Ji3, M. Katyal4, K. Margolin5
|
Abstract
Aim
A recent large pooled survival analysis has shown that ipilimumab (ipi) conveys long-term survival benefit in a significant proportion of patients (pts) with advanced melanoma (mel). We conducted a retrospective study of clinical outcomes and adverse events (AEs) among pts receiving ipi in a real world setting which may define whether longer survival is associated with increased HCRU. The present analysis describes HCRU by length of survival and baseline ECOG status.
Methods
This medical chart review comprised adult pts in the US with unresectable stage III/IV mel treated in a community setting with ≥1 dose of ipi 3 mg/kg as first-line monotherapy between 04/2011 and 09/2012. Demographic/clinical characteristics, details of ipi dosing and subsequent therapies, AEs, and HCRU (hospitalizations, emergency department (ED) visits, nursing home stays) were collected. Pts were categorized according to survival (<1 year vs. ≥1 year) and baseline ECOG status (0 vs. ≥1). HCRU per pt was compared using ANOVA and chi-square tests.
Results
Data were abstracted from 273 pt charts at 34 sites. As of 12/20/2013, 231 pts had been followed ≥1 year or until death, and 200 had ECOG status recorded. The 4 groups were similar in age (median 64 years), sex (66% male), and race (95% white). More hospitalizations per pt occurred among pts surviving <1 year vs. ≥1 year, and pts with ECOG status ≥1 vs. 0 (p < 0.001 for both). Pts who survived <1 year had more hospitalizations and hospital days if their baseline ECOG status was ≥1 compared to 0, while ECOG status did not appear to impact HCRU among pts who survived ≥1 year.
Conclusions
In this population, the rate of resource use was lower among those surviving ≥1 year than among those surviving <1 year. Baseline ECOG status ≥1 was associated with greater HCRU only among pts surviving <1 year. Prolonged survival appears to be associated with reduced HCRU among this patient population.
Healthcare Resource Utilization during Follow-Up, Mean (SD)
| Survived ≥1 yearECOG 0N = 55 | Survived ≥1 yearECOG ≥1N = 51 | Survived <1 yearECOG 0N = 26 | Survived <1 yearECOG ≥1N = 68 | |
|---|---|---|---|---|
| HospitalizationsNumber per pt per 100 days*Total days per pt per 100 days* | 0.08 (0.16)0.49 (1.17) | 0.09 (0.19)0.35 (0.79) | 0.50 (0.70)2.22 (3.45) | 1.13 (1.77)5.12 (8.93) |
| Emergency department visits, number per pt per 100 days | 0.01 (0.05) | 0.02 (0.11) | 0 (0) | 0.02 (0.07) |
| Nursing home staysPts (%)Total days per pt per 100 days | 1.8%0.04 (0.30) | 5.9%0.46 (2.01) | 7.7%1.63 (7.20) | 7.4%1.89 (9.00) |
* p < 0.001.
Disclosure
A. Tarhini: Advisory boards: Bristol-Myers Squibb, Merck, and Genentech; Corporate-sponsored research: Bristol-Myers Squibb, Merck, Novartis, Amgen, and Prometheus. A.S. Rao: Employee of Bristol-Myers Squibb. S. Corman: Employee of Pharmerit International; consulting fee or honorarium paid by Bristol-Myers Squibb to Pharmerit International. M. Botteman: employee of Pharmerit International; consulting fee from Bristol-Myers Squibb during the conduct of the study. S. Mehta: employee of Pharmerit International; consulting fee or honorarium paid by Bristol-Myers Squibb to Pharmerit International. X. Ji: employee of Pharmerit International; consulting fee or honorarium paid by Bristol-Myers Squibb to Pharmerit International. M. Katyal: Employee of Medical Data Analytics; corporate-sponsored research: Medical Data Analytics is consultant vendor to Bristol-Myers Squibb, Inc., the financial sponsor of this research study. K. Margolin: Corporate-sponsored research: GlaxoSmithKline, Bristol-Myers Squibb, Genentech, Pfizer, Altor, and Prometheus.