https://orcid.org/0000-0002-4578-9346
![Sample our Health and Social Care journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5938/TOC-Subject-Sample-2021-Health-Social-Care.jpg"})
Abstract
Aim: The main purpose of the present study was to investigate the labor market affiliation of ALK+ NSCLC patients in long-term treatment as well as overall survival and incidence/prevalence. Materials & methods: Nationwide retrospective study of all patients with ALK+ NSCLC in Denmark diagnosed between 2012 and 2018. Results: During the study period ALK+ NSCLC patients had a median overall survival of 44.0 months and a 7.8-fold increase in disease prevalence. Six months prior to diagnosis, 81% of ALK+ NSCLC patients ≤60 years of age were employed. At the end of the 18-month follow-up period, 36% were employed. Conclusion: ALK+ NSCLC patients have prolonged survival following diagnosis, but a large fraction of patients lose affiliation with the labor market.
Plain language summary
The purpose of this study was to examine the employment status and survival of patients with ALK+ NSCLC who are undergoing long-term treatment. The researchers conducted a study analyzing data from all such patients diagnosed between 2012 and 2018 in Denmark. The results showed that ALK+ NSCLC patients had a median overall survival of 44.0 months and a that the number of patients increased almost eightfold during the study period. Prior to diagnosis, 81% of ALK+ NSCLC patients who were 60 years of age or younger were employed. However, at the end of the 18-month follow-up period, only 36% of these patients were still employed. In conclusion, ALK+ NSCLC patients tend to have prolonged survival after diagnosis. However, a considerable proportion of these patients lose their affiliation with the labor market, indicating the impact of the disease on employment status.
Tweetable abstract
ALK+ NSCLC patients have prolonged survival following diagnosis, but a large fraction of patients lose affiliation with the labor market following diagnosis. #alkpositive #lcsm.
Returning to work after a cancer diagnosis is important for patients' financial stability and well-being, as well as for society's economic growth.
Returning to work after a lung cancer diagnosis is associated with young age and lessened treatment burden.
Patients with ALK+ NSCLC have improved survival, are often younger, and experience less treatment burden compared with chemotherapy-treated patients. We therefore hypothesized that such patients would be more likely to return to work following their diagnosis.
Using nationwide data of all ALK+ NSCLC patients diagnosed in Denmark between 2012 and 2018 we found:
An almost eightfold increase in prevalence of ALK+ NSCLC patients in the study period, possibly due to the gradual implementation of sensitive ALK testing in the different Danish lung cancer centers.
That ALK+ NSCLC patients live longer than NSCLC patients with-out targetable alterations.
That ALK+ NSCLC patients did not return to work following their diagnoses in greater numbers than what has historically been published for lung cancer patients in general.
We recommend that ALK+ NSCLC patients receive social and legal counseling to aid in maintaining an affiliation to the labor market following diagnosis.
Author contributions
All authors contributed to the study conception and design. Data collection was performed by JS Johansen, P Hjort-Hansen, M Parm Ulhøi, P Meldgaard, E Maria Urbanska, K Holmskov Hansen, C Kristiansen, B Højgaard and M Sall Jensen. Data analyses were performed by B Højgaard, M Sall Jensen and A Bondo Dydensborg. The first draft of the manuscript was written by A Bondo Dydensborg, and all authors reviewed the manuscript critically. All authors read and approved the final manuscript.
Financial disclosure
The study was funded and initiated by Takeda Pharma A/S, a subsidiary of Takeda Pharmaceuticals Inc. Authors A Bondo Dydensborg and C Dünweber are employees of Takeda Pharma A/S. P Meldgaard has received research funding from Roche, Takeda and Astra Zeneca, as well as consultancy fees from Amgen, Astra Zeneca, Roche, Sanofi, Pfizer and Takeda. E Maria Urbanska has received honorarium and consultancy fees from Roche, Amgen, Astra Zeneca, Novartis, Takeda and Pfizer. E Santoni-Rugiu has received consultancy/lecture honorarium from Amgen, Bayer, Roche, Sanofi, Takeda Astra Zeneca, Bristol Myers Squibb, Roche, Takeda, conference participation support from Takeda, and research grants from Roche and Sanofi. M Parm Ulhøi has received consultancy / lecture honorarium from Takeda, Pfizer, Amgen and Sanofi as well as conference participation support from Sanofi and MSD. JL Andersen has received honoraria for lectures, advisory boards, and congress expenses from Abbvie, Amgen, Astra Zeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Merck Sharp and Dohme (MSD), Novartis, Pfizer, Pierre Fabre, Roche, Sanofi and Takeda. M Stelmach has received honoraria for lectures and advisory board from Takeda. All other authors report no other conflicts of interest in this work. Authors B Højgaard and M Sall Jensen were employees of the Danish Center for Social Science Research (VIVE) and were contracted by Takeda Pharma to extract data from the National Registries and perform analysis in this matter. B Højgaard's and M Sall Jensen's employment with VIVE ended during the writing of the article, B Højgaard is now employed at Steno Diabetes Center, Copenhagen, Denmark and M Sall Jensen is now employed at Novo Nordisk, Søborg, Denmark. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
Competing interests disclosure
The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Ethical conduct of research
The study was approved by the Danish Patient Safety Authority (#3-3013-3274/1 and #3-3013-3161/1) and registered at the Danish Data Protection Agency. There are no Danish legislation requirements to obtain approval from ethics review committees nor obtaining informed consent from the patients to use the data in this study, as the patients were not contacted at any point during this study, the study did not affect the treatment of the patients, and only pseudonymized data were used.
Previous presentation
Presented at: World Conference on Lung Cancer (WCLC), 2021, Vienna [#795].
DOI:10.1016/j.jtho.2021.08.311.