Clinical management patterns and treatment outcomes in patients with non-small cell lung cancer (NSCLC) across Europe: EPICLIN-Lung study

Abstract

Background:

Throughout Europe, physicians face similar challenges in non-small cell lung cancer (NSCLC) management, but comprehensive international information on usual clinical practice is lacking so the burden of NSCLC is not fully understood.

Methods:

This multinational, multicentre, non-interventional study (NCT00831909) was conducted in eight European countries. Patients with confirmed NSCLC were consecutively enrolled from January to March 2009 and followed for 12 months or until death. Information was collected on patient and disease characteristics, diagnosis and treatment patterns, and clinical outcomes. Spontaneously reported adverse events (AEs) were also recorded.

Results:

Data were available for 3508 patients. Most patients (77.5%) were male, median (range) age was 65.0 years (21.6–90.7), the majority of patients had a World Health Organization performance status of ≤1 (74.7%), and 10.8% were never smokers. The most prevalent histologies were adenocarcinoma (43.8%) and squamous-cell carcinoma (29.4%). Most patients presented with advanced disease (11.6% with stage IIIA, 18.7% with stage IIIB, 48.6% with stage IV). In stage IV disease, median progression-free survival and overall survival (months) by first-line treatment cluster were platinum regimens: 6.5, 10.8; non-platinum regimens: 4.3, 8.5; regimens with bevacizumab 8.7, 12.9; investigational regimens: 5.6, 10.8; best supportive care: 5.4, 6.6. The most frequently reported severe (Common Terminology Criteria for Adverse Events v3.0 >2) AEs were blood/bone marrow (16.0%) and pulmonary/upper respiratory (7.8%). Key limitations of this study related to its non-interventional nature and wide regional focus; for example, achieving a representative sample of the overall NSCLC population, variation in recruitment between countries, and data based on information from medical records derived from routine visits.

Conclusions:

The Epidemiological Study to Describe NSCLC Clinical Management Pattern in Europe–Lung (EPICLIN-Lung) study provides new insights into the descriptive patterns and clinical management strategies for NSCLC across Europe, and how they affect patient outcomes.

Keywords::

• Carcinoma, non-small cell lung
• Disease management
• Epidemiology
• Europe
• Treatment outcomes

Transparency

Declaration of funding

EPICLIN-Lung was funded by AstraZeneca. AstraZeneca and the authors collaborated in the study design, and collection and interpretation of data. The decision to submit for publication was the lead author’s.

Declaration of financial/other relationships

A.C. has received consulting fees, honoraria and travel/accommodation expenses from AstraZeneca, and his institution has received data manager support from AstraZeneca for EPICLIN-Lung study data collection. A.V. has received payment for board membership from Roche, Lilly and AstraZeneca and has received grants (or has grants pending) from Chugai, Lilly, Boehringer Ingelheim, Roche, AstraZeneca and Pierre Fabre. M.T. has received consulting fees, honoraria, travel/accommodation expenses and payment for development of educational presentations from AstraZeneca. K.M. has received consultancy fees from Celgene Corporation, AstraZeneca, Worldwide Clinical Trials, Integrium LLC, Cypress Pharmaceuticals, Sigma-Tau Pharmaceuticals, Outcomes Research, Multiple Myeloma Research Foundation, MedImmune, ACT Oncology and BioSoteria. J.M. is an employee of AstraZeneca. G.C. has disclosed that he has no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgments

The authors thank Tom Westgate, PhD, from iMed Comms for assistance in manuscript preparation, which was funded by AstraZeneca.