RT Journal Article
SR Electronic
T1 Evaluating transportability of overall survival estimates from US to UK populations receiving first-line treatment for advanced non-small cell lung cancer: a retrospective cohort study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e085722
DO 10.1136/bmjopen-2024-085722
VO 14
IS 12
A1 Kent, Seamus
A1 Mpofu, Philani
A1 Duffield, Stephen
A1 Adam, Jane
A1 Beal, Brennan
A1 Royce, Trevor J
A1 Adamson, Blythe
A1 Kasturi, Jyotsna
A1 Sujenthiran, Arun
A1 Jónsson, Páll
YR 2024
UL http://bmjopen.bmj.com/content/14/12/e085722.abstract
AB Objectives The objective of this study is to explore how the UK versus the USA compare in patient characteristics, treatment patterns and overall survival (OS) of patients with advanced non-small cell lung cancer (aNSCLC) initiating first-line (1L) treatment.Design Retrospective cohort study.Setting Oncology treatment centres in the USA and UK.Participants People in the USA and UK diagnosed with aNSCLC and treated in the 1L setting between 2016 and 2018. The US cohort was obtained from a nationwide electronic health record-derived deidentified database. The UK cohort information was derived from a published study exploring the patient characteristics, treatments and outcomes of people with aNSCLC in the UK.Interventions 1L chemotherapy, immunotherapy monotherapy or targeted therapy.Primary outcome measure The primary outcome was OS—defined as the time from treatment initiation to death from any cause.Results There were 1003 patients in the UK and 3819 in the US cohorts receiving 1L therapy for aNSCLC. After standardising the US cohort to the UK cohort, median OS in the USA and UK was similar across 1L drug classes: chemotherapies (7.7 (95% CI 7.1 to 8.3) vs 8.1 (95% CI 7.4 to 8.9) months), immunotherapies (13.9 (95% CI 11.0 to 17.1) vs 14.0 (95% CI 10.7 to 20.6)) and targeted therapies (21.6 (95% CI 18.5 to 23.7) vs 20.2 (95% CI 16.0 to 30.5)). OS curves for 1L immunotherapy and targeted therapy were almost overlapping after standardisation. OS after around 12 months was higher in US patients compared with UK patients receiving 1L chemotherapy regimens. Of those receiving 1L chemotherapy, the proportion receiving any second-line therapy appeared higher for patients in the USA versus UK.Conclusions The results suggest that in aNSCLC patients receiving 1L treatment, US data have the potential to be used in technology evaluations to understand long-term OS where UK data are unavailable or sparse.Data are available on reasonable request. The data that support the findings of this study were originated by and are the property of Flatiron Health, Inc., which has restrictions prohibiting the authors from making the data set publicly available. Requests for data sharing by licence or by permission for the specific purpose of replicating results in this manuscript can be submitted to PublicationsDataAccess@flatiron.com.