Raja Mudad, Manish B Patel, Sandra Margunato-Debay, David Garofalo, Lincy S Lal
{"title":"纳布-紫杉醇加卡铂与吉西他滨加卡铂在美国社区肿瘤科一线治疗晚期鳞状细胞非小细胞肺癌的有效性和安全性比较。","authors":"Raja Mudad, Manish B Patel, Sandra Margunato-Debay, David Garofalo, Lincy S Lal","doi":"10.2147/LCTT.S139647","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Real-world comparative effectiveness, safety, and supportive care use of <i>nab</i>-paclitaxel plus carboplatin vs gemcitabine plus platinum were analyzed in patients with advanced or metastatic squamous cell non-small cell lung cancer (NSCLC).</p><p><strong>Materials and methods: </strong>Patients who received ≥ 1 cycle of first-line <i>nab</i>-paclitaxel plus carboplatin or gemcitabine plus platinum were identified from the Navigating Cancer database. Clinical effectiveness endpoints included overall survival (OS) and time to treatment discontinuation (TTD). Other endpoints included safety and utilization of supportive care. Cox proportional hazards models were used to control for potential confounding effects of baseline characteristics.</p><p><strong>Results: </strong>In total, 193 patients were included (<i>nab</i>-paclitaxel plus carboplatin, n = 61; gemcitabine plus platinum, n = 132). Baseline characteristics were generally similar between the cohorts. Patients receiving <i>nab</i>-paclitaxel plus carboplatin had a significantly longer OS than those receiving gemcitabine plus carboplatin (median, 12.8 vs 9.0 months; <i>P</i> = 0.03). However, the adjusted difference was not statistically significant (adjusted HR 1.55; 95% CI, 0.99-2.42; <i>P</i> = 0.06). <i>nab</i>-Paclitaxel plus carboplatin-treated patients had significantly longer TTD than gemcitabine plus carboplatin-treated patients (median, 4.3 vs 3.5 months; <i>P</i> = 0.03; adjusted HR 1.39; 95% CI, 1.01-1.90; <i>P</i> = 0.04). Grade 3 or 4 anemia and neutropenia were significantly lower in patients treated with <i>nab</i>-paclitaxel plus carboplatin vs gemcitabine plus carboplatin. Nausea and neuropathy (grade not specified) were significantly higher in the <i>nab</i>-paclitaxel plus carboplatin than the gemcitabine plus carboplatin group. No differences in supportive care use were observed between the cohorts.</p><p><strong>Conclusion: </strong>These real-world data support the effectiveness and safety of <i>nab</i>-paclitaxel plus carboplatin for first-line treatment of advanced squamous cell NSCLC.</p>","PeriodicalId":18066,"journal":{"name":"Lung Cancer: Targets and Therapy","volume":null,"pages":null},"PeriodicalIF":5.1000,"publicationDate":"2017-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ad/90/lctt-8-179.PMC5656340.pdf","citationCount":"0","resultStr":"{\"title\":\"Comparative effectiveness and safety of <i>nab</i>-paclitaxel plus carboplatin vs gemcitabine plus carboplatin in first-line treatment of advanced squamous cell non-small cell lung cancer in a US community oncology setting.\",\"authors\":\"Raja Mudad, Manish B Patel, Sandra Margunato-Debay, David Garofalo, Lincy S Lal\",\"doi\":\"10.2147/LCTT.S139647\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Real-world comparative effectiveness, safety, and supportive care use of <i>nab</i>-paclitaxel plus carboplatin vs gemcitabine plus platinum were analyzed in patients with advanced or metastatic squamous cell non-small cell lung cancer (NSCLC).</p><p><strong>Materials and methods: </strong>Patients who received ≥ 1 cycle of first-line <i>nab</i>-paclitaxel plus carboplatin or gemcitabine plus platinum were identified from the Navigating Cancer database. Clinical effectiveness endpoints included overall survival (OS) and time to treatment discontinuation (TTD). Other endpoints included safety and utilization of supportive care. Cox proportional hazards models were used to control for potential confounding effects of baseline characteristics.</p><p><strong>Results: </strong>In total, 193 patients were included (<i>nab</i>-paclitaxel plus carboplatin, n = 61; gemcitabine plus platinum, n = 132). Baseline characteristics were generally similar between the cohorts. Patients receiving <i>nab</i>-paclitaxel plus carboplatin had a significantly longer OS than those receiving gemcitabine plus carboplatin (median, 12.8 vs 9.0 months; <i>P</i> = 0.03). However, the adjusted difference was not statistically significant (adjusted HR 1.55; 95% CI, 0.99-2.42; <i>P</i> = 0.06). <i>nab</i>-Paclitaxel plus carboplatin-treated patients had significantly longer TTD than gemcitabine plus carboplatin-treated patients (median, 4.3 vs 3.5 months; <i>P</i> = 0.03; adjusted HR 1.39; 95% CI, 1.01-1.90; <i>P</i> = 0.04). Grade 3 or 4 anemia and neutropenia were significantly lower in patients treated with <i>nab</i>-paclitaxel plus carboplatin vs gemcitabine plus carboplatin. Nausea and neuropathy (grade not specified) were significantly higher in the <i>nab</i>-paclitaxel plus carboplatin than the gemcitabine plus carboplatin group. 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引用次数: 0
摘要
简介对晚期或转移性鳞状细胞非小细胞肺癌（NSCLC）患者使用纳布-紫杉醇加卡铂与吉西他滨加铂的实际效果、安全性和支持性治疗进行了比较分析：从 "癌症导航 "数据库中筛选出接受纳布-紫杉醇加卡铂或吉西他滨加铂治疗≥1个周期的一线患者。临床疗效终点包括总生存期（OS）和终止治疗时间（TTD）。其他终点包括安全性和支持性治疗的使用情况。采用Cox比例危险模型来控制基线特征的潜在混杂效应：共纳入193名患者（纳布紫杉醇加卡铂，n = 61；吉西他滨加铂，n = 132）。两组患者的基线特征基本相似。接受纳布-紫杉醇加卡铂治疗的患者的OS明显长于接受吉西他滨加卡铂治疗的患者（中位数，12.8个月 vs 9.0个月；P = 0.03）。纳布-紫杉醇加卡铂治疗患者的TTD明显长于吉西他滨加卡铂治疗患者（中位4.3个月 vs 3.5个月；P = 0.03；调整HR 1.39；95% CI，1.01-1.90；P = 0.04）。纳布-紫杉醇加卡铂与吉西他滨加卡铂相比，接受纳布-紫杉醇加卡铂治疗的患者3级或4级贫血症和中性粒细胞减少症明显减少。纳布-紫杉醇加卡铂组患者的恶心和神经病变（等级不详）明显高于吉西他滨加卡铂组。两组患者在使用支持性护理方面没有差异：这些实际数据支持纳布-紫杉醇加卡铂一线治疗晚期鳞状细胞NSCLC的有效性和安全性。
Comparative effectiveness and safety of nab-paclitaxel plus carboplatin vs gemcitabine plus carboplatin in first-line treatment of advanced squamous cell non-small cell lung cancer in a US community oncology setting.
Introduction: Real-world comparative effectiveness, safety, and supportive care use of nab-paclitaxel plus carboplatin vs gemcitabine plus platinum were analyzed in patients with advanced or metastatic squamous cell non-small cell lung cancer (NSCLC).
Materials and methods: Patients who received ≥ 1 cycle of first-line nab-paclitaxel plus carboplatin or gemcitabine plus platinum were identified from the Navigating Cancer database. Clinical effectiveness endpoints included overall survival (OS) and time to treatment discontinuation (TTD). Other endpoints included safety and utilization of supportive care. Cox proportional hazards models were used to control for potential confounding effects of baseline characteristics.
Results: In total, 193 patients were included (nab-paclitaxel plus carboplatin, n = 61; gemcitabine plus platinum, n = 132). Baseline characteristics were generally similar between the cohorts. Patients receiving nab-paclitaxel plus carboplatin had a significantly longer OS than those receiving gemcitabine plus carboplatin (median, 12.8 vs 9.0 months; P = 0.03). However, the adjusted difference was not statistically significant (adjusted HR 1.55; 95% CI, 0.99-2.42; P = 0.06). nab-Paclitaxel plus carboplatin-treated patients had significantly longer TTD than gemcitabine plus carboplatin-treated patients (median, 4.3 vs 3.5 months; P = 0.03; adjusted HR 1.39; 95% CI, 1.01-1.90; P = 0.04). Grade 3 or 4 anemia and neutropenia were significantly lower in patients treated with nab-paclitaxel plus carboplatin vs gemcitabine plus carboplatin. Nausea and neuropathy (grade not specified) were significantly higher in the nab-paclitaxel plus carboplatin than the gemcitabine plus carboplatin group. No differences in supportive care use were observed between the cohorts.
Conclusion: These real-world data support the effectiveness and safety of nab-paclitaxel plus carboplatin for first-line treatment of advanced squamous cell NSCLC.
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