Evidence map›Paper›PMID 33016001›Full record

ArticleThoracic cancer2020

Real-life effectiveness of first-line anticancer treatments in stage IIIB/IV NSCLC patients: Data from the Czech TULUNG Registry.

Kristian Brat, Monika Bratova, Jana Skrickova, Magda Barinova, Karolina Hurdalkova, Milos Pesek, Libor Havel, Leona Koubkova, Michal Hrnciarik, Jana Krejci and 4 more

Open access · goldAbstract read
In one paragraph

Article in Thoracic cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 7 institutions in 1 country.

Kristian BratDepartment of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic.
Monika BratovaDepartment of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic.ORCID 0000-0001-9994-480X
Jana SkrickovaDepartment of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic.
Magda BarinovaInstitute of Biostatistics and Analyses, Ltd., Brno, Czech Republic.
Karolina HurdalkovaInstitute of Biostatistics and Analyses, Ltd., Brno, Czech Republic.
Milos PesekDepartment of Pneumology, University Hospital Pilsen, Pilsen, Czech Republic.
Libor HavelDepartment of Respiratory Medicine, Thomayer Hospital, Prague, Czech Republic.
Leona KoubkovaDepartment of Pneumology, University Hospital Motol, Prague, Czech Republic.
Michal HrnciarikDepartment of Pneumology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
Jana KrejciDepartment of Pneumology and Thoracic Surgery, Bulovka Hospital, Prague, Czech Republic.
Ondrej FischerDepartment of Respiratory Medicine, University Hospital Olomouc, Olomouc, Czech Republic.
Milada ZemanovaDepartment of Oncology, General Teaching Hospital, Prague, Czech Republic.
Helena CoupkovaClinic of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
Martin SvatonDepartment of Pneumology, University Hospital Pilsen, Pilsen, Czech Republic.
Charles University · CZMasaryk University · CZCzech Academy of Sciences, Institute of Biophysics · CZFakultní nemocnice Bulovka · CZMasaryk Memorial Cancer Institute · CZThomayer University Hospital · CZUniversity Hospital Olomouc · CZ

Funding

Ministerstvo Zdravotnictví Ceské Republiky MH CZ-DRO FNBr 65269705
6 · The paper itself

Abstract

backgroundData regarding real-life effectiveness of any treatment may improve clinical decision-making. The aim of this study was to evaluate real-life effectiveness of tyrosin-kinase inhibitors, bevacizumab and pemetrexed as first-line treatments in patients with advanced/metastatic non-small cell lung cancer (NSCLC).

methodsWe analyzed data of 2157 patients of the Czech TULUNG Registry of patients with advanced/metastatic NSCLC who received modern-era treatments between 2011 and 2018. Patients treated with gefitinib, erlotinib, afatinib, bevacizumab (+ maintenance), pemetrexed (+ maintenance) as first-line therapy were included in the study. A systematic literature search separately identified clinical trials suitable for calculation of comparator pooled OS and PFS for each regimen. For each subgroup, basic characteristics and survival data (Kaplan-Meier estimates) are shown. We propose the "index of real-life effectiveness" (IRE), a ratio of real-life OS/PFS and comparator pooled OS/PFS. Univariate and multivariate logistic regression identified factors were associated with longer OS (ie, IRE>1.1).

resultsSurvival analysis showed median OS of 23 months for erlotinib, 29.3 months for afatinib, 19.6 months for gefitinib, 12.2 months for pemetrexed, 17.5 months for pemetrexed maintenance, 15.8 months for bevacizumab and 15.8 months for bevacizumab maintenance. Calculated IREs for OS for the regimens were: erlotinib 1.013, afatinib 1.184, gefitinib 0.736, pemetrexed 1.188, pemetrexed maintenance 1.294, bevacizumab 1.178, and bevacizumab maintenance 1.189. Multivariate regression analysis showed that these factors were associated with longer OS: lower PS for afatinib; lower PS, absence of adverse events and female sex for bevacizumab; and lower PS and female sex for pemetrexed.

conclusionsThis study clearly demonstrated that real-life effectiveness of certain treatment regimens may strongly differ in various populations/health care systems, and comparison between TULUNG data and pooled survival data from trials showed higher real-life effectiveness for most of the studied first-line regimens. Lower ECOG PS, younger age, female sex and adverse events were associated with longer survival in most regimens. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: Comparison between TULUNG data and pooled survival data from trials showed higher real-life effectiveness for most of the studied first-line regimens; for most regimens, lower ECOG PS, younger age, female sex and adverse events were associated with longer survival. WHAT THIS STUDY ADDS: Real-life effectiveness of certain treatment regimens may strongly differ in various populations/health care systems.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Non-Small-Cell LungCzech RepublicFemaleHumansLung NeoplasmsMaleMiddle AgedNeoplasm StagingRegistriesSurvival AnalysisAnticancer treatmentnon-small cell lung cancerprogression-free survivalreal-life effectivenesstyrosinkinase inhibitors

Identifiers

PMID33016001
PMCPMC7606010
OpenAlexW3091006069

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.