Comparison of real-world acute care interventions (ACI) in patients (pts) with advanced non-small cell lung cancer (adv NSCLC) treated with chemotherapy versus targeted therapies.

37 Background: This analysis compared the frequency of ACI for any cause (emergency room [ER] visits, hospitalizations, and readmissions) to better understand the burden of treatment in adv NSCLC pts treated with chemotherapy (chemo) vs targeted therapy (TT).

METHODS: Using Inovalon's MORE(2) Registry claims data, adv NSCLC pts treated with antineoplastics identified by ICD-9 codes from July 2013-2014 were selected. Inclusion: pts >18 y who received first-line (1L) systemic therapy within 6 mo of diagnosis. Exclusion: pts with small cell lung cancer or secondary malignancies and pts in clinical trials. TT was defined as erlotinib, ceritinib, afatinib, crizotinib, ramucirumab, or bevacizumab monotherapy. Analysis included frequency distributions, chi-square, and t-tests.

RESULTS: Of 5319 pts included, 1304 (25%) received 1821 total lines of TT. Overall, median age was 66 y, 48% were male, 56% were on Medicare, and 41% received ≥ 2 L of therapy. Mean Charlson Comorbidity Index (CCI) was 2.2 (lower in pts on TT [2.1 vs. 2.2, P<.0001]). Pts on TT were older, more likely to be female, and less likely to have Medicare (Table). Overall, 45% of pts were hospitalized, of whom 50% were readmitted (43% while on the same line); 62% of pts had an ER visit, of whom 62% were readmitted (56% while on the same line). Pts on TT were less likely to be hospitalized, have ER visits, and be readmitted (hospital or ER).

CONCLUSIONS: Pts with adv NSCLC had considerable ACI. Readmission was common for both hospitalizations and ER visits, with many pts readmitted while on the same line. Pts on TT had fewer ACI and readmissions vs pts on chemo; however, nearly half of pts in this study required hospitalization, highlighting the need for novel therapies with improved safety and efficacy. [Table: see text].