Abstract
BackgroundDetailed epidemiologic descriptions of large populations of advanced stage ovarian cancer patients have been lacking to date. This study aimed to describe the patient characteristics, treatment patterns, survival, and incidence rates of health outcomes of interest (HOI) in a large cohort of advanced stage ovarian cancer patients in the United States (US).MethodsThis cohort study identified incident advanced stage (III/IV) ovarian cancer patients in the US diagnosed from 2010 to 2018 in the HealthCore Integrated Research Database (HIRD) using a validated predictive model algorithm. Descriptive characteristics were presented overall and by treatment line. The incidence rates and 95% confidence intervals for pre-specified HOIs were evaluated after advanced stage diagnosis. Overall survival, time to treatment discontinuation or death (TTD), and time to next treatment or death (TTNT) were defined using treatment information in claims and linkage with the National Death Index.ResultsWe identified 12,659 patients with incident advanced stage ovarian cancer during the study period. Most patients undergoing treatment received platinum agents (75%) and/or taxanes (70%). The most common HOIs (> 24 per 100 person-years) included abdominal pain, nausea and vomiting, anemia, and serious infections. The median overall survival from diagnosis was 4.5 years, while approximately half of the treated cohort had a first-line time to treatment discontinuation or death (TTD) within the first 4 months, and a time to next treatment or death (TTNT) from first to second-line of about 6 months.ConclusionsThis study describes commercially insured US patients with advanced stage ovarian cancer from 2010 to 2018, and observed diverse treatment patterns, incidence of numerous HOIs, and limited survival in this population.
Highlights
Detailed epidemiologic descriptions of large populations of advanced stage ovarian cancer patients have been lacking to date
Randomized trials have suggested that adverse events including hypertension, neutropenia, liver-related toxicity, fatigue, anemia and diarrhea can occur commonly after initiation of certain ovarian cancer therapies, [4,5,6] but less is known about the incidence and types of health outcomes of interest (HOIs) occurring in the general ovarian cancer population
We developed a validated algorithm to define advanced stage ovarian cancer using supervised machine learning techniques [11]. We applied this algorithm to an administrative claims database to identify a large cohort of advanced stage ovarian cancer patients and described their characteristics, treatment patterns, survival, and incidence rates of HOIs that could be utilized as comparator incidence rates for new and future ovarian cancer therapies indicated for advanced stage ovarian cancer
Summary
Detailed epidemiologic descriptions of large populations of advanced stage ovarian cancer patients have been lacking to date. This study aimed to describe the patient characteristics, treatment patterns, survival, and incidence rates of health outcomes of interest (HOI) in a large cohort of advanced stage ovarian cancer patients in the United States (US). Many new treatments, including poly ADP-ribose polymerase (PARP) inhibitors, are indicated for advanced stage ovarian cancer, [2] while potential new therapies, such as immunotherapies, are being investigated [3]. Randomized trials have suggested that adverse events including hypertension, neutropenia, liver-related toxicity, fatigue, anemia and diarrhea can occur commonly after initiation of certain ovarian cancer therapies, [4,5,6] but less is known about the incidence and types of health outcomes of interest (HOIs) occurring in the general ovarian cancer population. Recent publications have suggested that trial populations are significantly younger, have higher income, and have fewer co-morbidities than the general cancer population [7,8,9]
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