Baseline Patient-Reported Quality-of-Life Is Not Related to Overall Survival in Patients Receiving Stereotactic Body Radiation Therapy for Thoracic Malignancies: A Preliminary Report

Abstract

(NSQ) histology and have expanded to include oral targeted therapies. This study examines oral and infused SATx by line of therapy (LOT) and histology in a more recent population-based cohort. Materials/Methods: Patients aged 66 who had Medicare Parts A/B/D fee-for-service insurance coverage and were diagnosed with stage IIIB/IV NSCLC in 2007-9 were identified in the United States SEER-Medicare data and classified as squamous (SQ), NSQ, or unclassified histology (not otherwise specified [NOS]). We examined patients’ demographic and clinical characteristics, patterns of SATx (chemotherapy, tyrosine kinase inhibitors, and monoclonal antibodies), and the relationship of SATx to histology. Results: Of 7080 eligible patients, 26% had SQ, 51% had NSQ, and 24% had NOS histology; 28% were stage IIIB and 72% stage IV. Overall, 44% of all patients received at least first-line (1L) SATx (NSQ 46%, SQ 41%, NOS 43%; PZ.0013 across all categories and PZ.0006 for NSQ vs SQ). Only 19% of all patients received secondline (2L) SATx (NSQ 21%, SQ 16%, NOS 18%; P<.0001 across all categories and for NSQ vs SQ); expressed as a proportion of patients who received 1L, 43% received 2L (NSQ 45%, SQ 37%, NOS 42%; PZ.0014 across all categories and PZ.0003 for NSQ vs SQ). Eight percent of all patients received a third-line (3L) of SATx (NSQ 9%, SQ 6%, NOS 7%; PZ.0019 across all categories and PZ.0016 for NSQ vs SQ); expressed as a proportion of patients who received 2L, 40% received 3L (NSQ 41%, SQ 40%, NOS 38%; PZ.51 across all categories and PZ.73 for NSQ vs SQ). SATx was variable, with 48, 67, and 64 distinct regimens observed in 1L, 2L, and 3L, respectively. Carboplatin-paclitaxel (33%) and erlotinib (14%) were the most common 1L regimens; pemetrexed (2LZ20%; 3LZ21%) and erlotinib (2LZ17%; 3LZ20%) were the most common SATxs in 2L and 3L. Conclusions: Despite recent innovations in SATx for adv NSCLC, more than half of patients do not receive 1L SATx, with progressively fewer receiving 2L and 3L. SQ patients are less likely than NSQ patients to receive SATx across all lines, possibly related to fewer options for SQ patients. Author Disclosure: L.S. Orsini: A. Employee; Bristol-Myers Squibb. M. Stock; Bristol-Myers Squibb. B. Korytowsky: A. Employee; BristolMyers Squibb. M. Stock; Bristol-Myers Squibb. A. Petrilla: A. Employee; IMS Health. J.P. Wisnivesky: E. Research Grant; GlaxoSmithKline, Aventis. F. Honoraria; IMS Health, Merck. G. Consultant; EHE International. C. Craver: E. Research Grant; University of North Carolina at Charlotte. M. Salvati: A. Employee; Bristol-Myers Squibb. M. Stock; Bristol-Myers Squibb. D. Hines: None. P.Z. Donga: A. Employee; IMS Health. C. Blanchette: None. R.L. Wade: E. Research Grant; BristolMyers Squibb. J.R. Penrod: A. Employee; Bristol-Myers Squibb. M. Stock; Bristol-Myers Squibb.