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Current Oncology
Volume 27
Issue 6
10.3747/co.27.6563
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Longitudinal Health Utilities, Symptoms and Toxicities in Patients with ALK-Rearranged Lung Cancer Treated with Tyrosine Kinase Inhibitors: A Prospective Real-World Assessment

by
B.C. Tse
,
B.I. Said
,
Z.J. Fan
,
K. Hueniken
,
D. Patel
,
G. Gill
,
M. Liang
,
M. Razooqi
,
M.C. Brown
,
A.G. Sacher
,
P.A. Bradbury
,
F.A. Shepherd
,
N.B. Leighl
,
W. Xu
,
D. Howell
,
G. Liu
* and
G. O’Kane
1
Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
2
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
3
Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada
4
Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
5
Department of Epidemiology, Dalla Lana School of Public Health, Toronto, ON, Canada
6
Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2020, 27(6), 552-559; https://doi.org/10.3747/co.27.6563
Submission received: 9 September 2020 / Revised: 4 October 2020 / Accepted: 6 November 2020 / Published: 1 December 2020

Abstract

Background: Tyrosine kinase inhibitors (TKIs) have dramatically improved the survival of patients with ALK-rearranged (ALK+) non-small-cell lung cancer (NSCLC). Clinical trial data can generally compare drugs in a pair-wise fashion. Real-world collection of health utility data, symptoms, and toxicities allows for the direct comparison between multiple TKI therapies in the population with ALK+ NSCLC. Methods: In a prospective cohort study, outpatients with ALK+ recruited between 2014 and 2018, treated with a variety of TKIs, were assessed every 3 months for clinico-demographic, patient-reported symptom and toxicity data and EQ-5D-derived health utility scores (HUS). Results: In 499 longitudinal encounters of 76 patients with ALK+ NSCLC, each TKI had stable longitudinal HUS when disease was controlled, even after months to years: the mean overall HUS for each TKI ranged from 0.805 to 0.858, and longitudinally from 0.774 to 0.912, with higher values associated with second- or third-generation TKIs of alectinib, brigatinib, and lorlatinib. Disease progression was associated with a mean HUS decrease of 0.065 (95% confidence interval: 0.02 to 0.11). Health utility scores were inversely correlated to multiple symptoms or toxicities: rho values ranged from −0.094 to −0.557. Fewer symptoms and toxicities were associated with the second- and third-generation TKIs compared with crizotinib. In multivariable analysis, only stable disease state and baseline Eastern Cooperative Oncology Group performance status were associated with improved HUS. Conclusions: There was no significant decrease in HUS when patients with ALK+ disease were treated longitudinally with each TKI, as long as patients were clinically stable. Alectinib, brigatinib, and lorlatinib had the best toxicity profiles and exhibited high mean HUS longitudinally in the real-world setting.
Keywords: health utility; real-world studies health utility; real-world studies

Share and Cite

MDPI and ACS Style

Tse, B.C.; Said, B.I.; Fan, Z.J.; Hueniken, K.; Patel, D.; Gill, G.; Liang, M.; Razooqi, M.; Brown, M.C.; Sacher, A.G.; et al. Longitudinal Health Utilities, Symptoms and Toxicities in Patients with ALK-Rearranged Lung Cancer Treated with Tyrosine Kinase Inhibitors: A Prospective Real-World Assessment. Curr. Oncol. 2020, 27, 552-559. https://doi.org/10.3747/co.27.6563

AMA Style

Tse BC, Said BI, Fan ZJ, Hueniken K, Patel D, Gill G, Liang M, Razooqi M, Brown MC, Sacher AG, et al. Longitudinal Health Utilities, Symptoms and Toxicities in Patients with ALK-Rearranged Lung Cancer Treated with Tyrosine Kinase Inhibitors: A Prospective Real-World Assessment. Current Oncology. 2020; 27(6):552-559. https://doi.org/10.3747/co.27.6563

Chicago/Turabian Style

Tse, B.C., B.I. Said, Z.J. Fan, K. Hueniken, D. Patel, G. Gill, M. Liang, M. Razooqi, M.C. Brown, A.G. Sacher, and et al. 2020. "Longitudinal Health Utilities, Symptoms and Toxicities in Patients with ALK-Rearranged Lung Cancer Treated with Tyrosine Kinase Inhibitors: A Prospective Real-World Assessment" Current Oncology 27, no. 6: 552-559. https://doi.org/10.3747/co.27.6563

APA Style

Tse, B. C., Said, B. I., Fan, Z. J., Hueniken, K., Patel, D., Gill, G., Liang, M., Razooqi, M., Brown, M. C., Sacher, A. G., Bradbury, P. A., Shepherd, F. A., Leighl, N. B., Xu, W., Howell, D., Liu, G., & O’Kane, G. (2020). Longitudinal Health Utilities, Symptoms and Toxicities in Patients with ALK-Rearranged Lung Cancer Treated with Tyrosine Kinase Inhibitors: A Prospective Real-World Assessment. Current Oncology, 27(6), 552-559. https://doi.org/10.3747/co.27.6563

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