The standard of care for patients (pts) with recurrent ovarian cancer (OC) who respond to platinum-based chemotherapy has been “watchful waiting”. While studies have shown that pts experience anxiety and fear of recurrence during watchful waiting, the rate of serious clinical events that require hospitalizations or emergency room (ER) visits during this observation period has not been examined. The objective of this study was to assess the rate of such events using a claims database.
This retrospective study identified pts newly diagnosed with OC in January 2009 to September 2015 in MarketScan® Commercial and Medicare Supplemental Databases (US). Pts with commercial or Medicare coverage for 12 months prior to and ≥1 month after first diagnosis were included. Recurrence was defined by the presence of 2nd-line platinum-based therapy, and watchful waiting as the period without active treatment following chemotherapy. Rate of inpatient admissions and ER visits during watchful waiting were assessed.
1312 pts were identified who had a treatment-free interval after 2nd-line platinum treatment. During this watchful waiting period (median duration, 162 days), 30.1% had an inpatient admission and 27.4% had an ER visit. Median time to first hospitalization from end of 2nd-line chemotherapy was 56 days, and median time to first ER visit was 68 days. There was a total of 650 inpatient hospitalizations, for an average of 0.5 per pt. Mean length of stay per hospitalization was 10 days. Top 5 reasons for hospitalizations were (1) intestinal obstruction without mention of hernia (13.5%), (2) secondary malignant neoplasm of respiratory and digestive systems (10.5%), (3) malignant neoplasm of ovary and other uterine adnexa (9.2%), (4) septicemia (4.5%), and (5) secondary malignant neoplasm of other specified sites (4.2%).
A substantial proportion of 2nd-line recurrent OC pts were hospitalized or had ER visits during the watchful waiting period post platinum treatment. The timing of these hospitalizations suggests that they were not necessarily related to progression but rather reflective of the ongoing disease burden patients experience during this “waiting” period.
Clinical trial identification
Legal entity responsible for the study
B. Harrow, K. Travers, M. Bala: Employment: Tesaro; Stock: Tesaro. B. Davis, A. Gilligan: Employment: Truven Health Analytics. All other authors have declared no conflicts of interest.