Abstract 5810
Background
To assess the incremental cost associated with the management of patients with primary non-squamous non-small cell lung cancer (NSCLC) with brain metastases (BM) at the time of diagnosis
Methods
A retrospective database analysis was performed using the French exhaustive Hospital medical information database (PMSI). Patients with metastatic lung cancer were identified through a combination of ICD-10 diagnosis codes: C34* for lung cancer combined with at least one metastasis code (C77*, C78*, C79*). All such patients hospitalised with metastatic lung cancer for the first time in 2013 were eligible. Those with at least one prescription of bevacizumab or pemetrexed at the index stay or during the 24-month following period were considered to have non-squamous NSCLC. Two cohorts were identified, one with BM and one with metastases at other sites. For each patient, total in-hospital medical resource consumption associated with the initial stay in 2013 and with any follow-up stays in the following 24 months was documented. Costs were attributed from official French national tariffs and expressed in 2017 Euros.
Results
The study included 1,529 patients with other metastases (62.6 ± 9.8 years old; 69.0% of men) and 971 patients with BM (58.6 ± 9.1 years old; 59.3% of men). The mean number of hospitalisations in the 24-month follow-up period was 17 per patient with other metastases and 21 per patient with BM. >99% of patients in both groups received chemotherapy. 57.7% patients with BM and 12.9% patients with other metastases were managed by radiotherapy. 37.2% patients with BM and 23.5% patients with other metastases received palliative care. 942 patients with other metastases and 695 with BM died during hospitalisation within two years (61.6% vs 71.6%). The associated cost was € 2,979 per patient-month for those with BM and € 2,426 for those with other metastases, representing a differential cost of € 553 per month. Radiotherapy (+€164/month) and palliative care (+€130/month) were the principal drivers of the incremental cost).
Conclusions
The presence of BM at the time of diagnosis of non-squamous NSCLC carries a significant burden, and ways of lowering it are needed.
Clinical trial identification
Legal entity responsible for the study
Bertrand Tehard.
Funding
Roche SAS France.
Editorial Acknowledgement
Disclosure
N. Girard, A. Cortot: Member of advisory board for this project: Roche SAS. D. Cozzone: Employee: Roche SAS. L. de Léotoing, C. Tournier, A. Vainchtock: Employee: HEV, Roche SAS contracted with HEVA to conduct analyses on this project. B. Tehard: Employee: Roche SAS France.
Resources from the same session
5877 - TCR beta chain convergence defines the tumor infiltrating T cell repertoire of melanoma and non-small cell lung carcinoma.
Presenter: Timothy Looney
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
3212 - PI3K inhibition and modulation of immune and tumor microenvironment markers by copanlisib in patients with non-Hodgkin's lymphoma or advanced solid tumors
Presenter: Ahmad Awada
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
3574 - Pan-squamous genomic profiling stratified by anatomic tumor site and viral association
Presenter: Meagan Montesion
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
4113 - Toward the Standardization of Bioinformatics Methods for the Accurate Assessment of Tumor Mutational Burden (TMB)
Presenter: Han Chang
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
4468 - Prediction of primary resistance to anti-PD1 therapy (APD1) in 2nd line NSCLC
Presenter: Egbert Smit
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
4570 - Immunomodulatory germline variation impacts the development of multiple primary melanoma (MPM).
Presenter: Robert Ferguson
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
1169 - Leukocyte telomere length and recurrence risk after EGFR-TKIs therapy in patients with advanced lung adenocarcinoma
Presenter: Ming Yang
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
1707 - Gene embedding: a novel machine learning approach to identify gene candidates related to immunotherapy responsiveness
Presenter: Chi Tung Choy
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
2123 - Common and rare DPYD variants are predictive for 5FU/capecitabine (5FU) toxicity: The MRC COIN and COIN-B trials
Presenter: Ayman Madi
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
5671 - The landscape of NTRK fusions in Chinese solid tumor patients
Presenter: Qi Ling
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract