Burden of chemotherapy-induced myelosuppression among patients with extensive-stage small cell lung cancer: A retrospective study from community oncology practices.

Autor: Hart L; Florida Cancer Specialists & Research Institute, Florida, Fort Myers, USA.; Wake Forest University School of Medicine, North Carolina, Winston-Salem, USA., Ogbonnaya A; Wake Forest University School of Medicine, North Carolina, Winston-Salem, USA., Boykin K; Florida Cancer Specialists & Research Institute, Florida, Fort Myers, USA., Deyoung K; Xcenda LLC, Texas, Carrolton, USA., Bailey R; Florida Cancer Specialists & Research Institute, Florida, Fort Myers, USA., Heritage T; Florida Cancer Specialists & Research Institute, Florida, Fort Myers, USA., Lopez-Gonzalez L; G1 Therapeutics, Inc., North Carolina, Research Triangle Park, USA., Huang H; G1 Therapeutics, Inc., North Carolina, Research Triangle Park, USA., Gordan L; Florida Cancer Specialists & Research Institute, Florida, Fort Myers, USA.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2023 Apr; Vol. 12 (8), pp. 10020-10030. Date of Electronic Publication: 2023 Mar 31.
DOI: 10.1002/cam4.5738
Abstrakt: Background: Myelosuppression is a major dose-limiting complication of chemotherapy for patients with extensive-stage small cell lung cancer (ES-SCLC). The objective was to describe the burden of myelosuppression, treatment patterns, and supportive care use among patients with ES-SCLC treated with chemotherapy in a US community oncology setting.
Methods: This retrospective cohort study used structured electronic medical record (EMR) data from the Florida Cancer Specialists & Research Institute between January 2013 and December 2020. Adult patients with ES-SCLC who were treated with chemotherapy between September 2013 and November 2020 were identified. The index date was the date of the first chemotherapy-containing line of therapy (LOT). Patients were followed for a minimum of 30 days after index (unless patient died) until December 31, 2020, or end of activity in the EMR data, whichever occurred first. Incidence and frequency of myelosuppressive episodes/events, treatment patterns, eligibility for red blood cell (RBC) or platelet transfusions, and supportive care use (granulocyte colony-stimulating factor [G-CSF], erythropoiesis-stimulating agents [ESAs], intravenous [IV] hydration) during the follow-up period were reported.
Results: The study population included 1239 patients. Most (94.0%) patients started first-line chemotherapy at index. During follow-up and across all chemotherapy-containing LOTs, 1222 (98.6%) patients had at least 1 myelosuppressive episode; 62.1% of patients had grade ≥ 3 myelosuppressive episodes in at least one lineage, 33.9% had grade ≥ 3 myelosuppressive episodes in at least two lineages, and 15.5% had grade ≥ 3 myelosuppressive episodes in all three lineages. Supportive care use included 89.7% of patients who received G-CSF, 24.4% who received ESAs, and 52.1% who received IV volume expansion. Almost one-third (32.6%) of patients were eligible to receive RBC transfusions based on lab values (hemoglobin < 8 g/dL).
Conclusion: There is a high burden related to multilineage myelosuppression among chemotherapy-treated patients with ES-SCLC in the community oncology setting. Reducing myelosuppression could make chemotherapy treatment safer, reduce the need for supportive care, and potentially prevent the treatment of complications.
(© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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