Real-world treatment patterns of non-small cell lung cancer in an Indian hospital.

Abstract

e18604 Background: The circumstances regarding lung cancer in India are similar to many countries around the world – it is one of the most commonly diagnosed cancers with many treatment options available. India, however, relies heavily on an out-of-pocket healthcare payment model in which patients are often directly responsible for the majority of these treatment costs. This paradigm makes many of the newer generation of medications financially inaccessible for most Indians. In this research, we aimed to understand the current treatment patterns of non-small cell lung cancer (NSCLC) from an analysis of Indian hospital data, as a way to contextualize the real-world treatment situation. Methods: Electronic Medical Record (EMR) data was sourced from a major cancer hospital located in India’s national capital region. Using the Querent health analytics platform, EMR data across 5 years (2017-2022) were analyzed. Demographics, disease characteristics, and treatment patterns were identified through a combination of structured and unstructured data including data from registration, laboratory, radiology, diagnosis, procedure, pharmacy, and clinical notes. Results: 1,227 unique patients with NSCLC were observed in the hospital over five years, with an average (SD) duration of observation time of 12.1 (15.4) months. The patients were, on average (SD), 59.0 (11.2) years old and were more likely to be male (69.4%). Most patients were in later cancer stages, with a distribution of I (3%), II (2%), III (13%), and IV (82%). Among those with metastatic NSCLC, 773 (76%) received cancer treatment at the hospital, with 52% receiving surgery, 5% radiotherapy, and 88% anti-cancer medication. The most commonly administered medications were chemotherapies (carboplatin (52%) and pemetrexed (38%)). Targeted therapies were administered in 55% of patients. Conclusions: Only about half of all metastatic NSCLC patients received targeted cancer therapy. This proportion pales in comparison to targeted therapy utilization rates observed in the US and Europe, indicating the need to address the affordability issues that hamper patient access to these medications. Increased adoption of advanced therapeutics could lead to improved outcomes for many patients in India.