Annals of Oncology 25 (Supplement 4): iv374–iv393, 2014 doi:10.1093/annonc/mdu344.17
melanoma and other skin tumours 1101P
abstracts
A. Tarhini1, A.S. Rao2, S. Corman3, M. Botteman3, S. Mehta3, X. Ji3, M. Katyal4, K. Margolin5 1 Division of Hematology/oncology, University of Pittsburgh Schools of the Health Sciences, Pittsburgh, PA, USA 2 HEOR, Oncology, Bristol-Myers Squibb, Plainsboro, NJ, USA 3 Outcomes Research, Pharmerit International, Bethesda, MD, USA 4 HEOR, Medical Data Analytics, Parsippany, NJ, USA 5 Medical Oncology, Seattle Cancer Care Alliance, Seattle, WA, USA
Aim: A recent large pooled survival analysis has shown that ipilimumab (ipi) conveys long-term survival benefit in a significant proportion of patients ( pts) with advanced melanoma (mel). We conducted a retrospective study of clinical outcomes and adverse events (AEs) among pts receiving ipi in a real world setting which may define whether longer survival is associated with increased HCRU. The present analysis describes HCRU by length of survival and baseline ECOG status. Methods: This medical chart review comprised adult pts in the US with unresectable stage III/IV mel treated in a community setting with ≥1 dose of ipi 3 mg/kg as first-line monotherapy between 04/2011 and 09/2012. Demographic/clinical characteristics, details of ipi dosing and subsequent therapies, AEs, and HCRU (hospitalizations, emergency department (ED) visits, nursing home stays) were collected. Pts were categorized according to survival (<1 year vs. ≥1 year) and baseline ECOG status (0 vs. ≥1). HCRU per pt was compared using ANOVA and chi-square tests. Results: Data were abstracted from 273 pt charts at 34 sites. As of 12/20/2013, 231 pts had been followed ≥1 year or until death, and 200 had ECOG status recorded. The 4 groups were similar in age (median 64 years), sex (66% male), and race (95% white). More hospitalizations per pt occurred among pts surviving <1 year vs. ≥1 year, and pts with ECOG status ≥1 vs. 0 ( p < 0.001 for both). Pts who survived <1 year had more hospitalizations and hospital days if their baseline ECOG status was ≥1 compared to 0, while ECOG status did not appear to impact HCRU among pts who survived ≥1 year. Conclusions: In this population, the rate of resource use was lower among those surviving ≥1 year than among those surviving <1 year. Baseline ECOG status ≥1
Table: 1101P Healthcare Resource Utilization during Follow-Up, Mean (SD)
Hospitalizations Number per pt per 100 days* Total days per pt per 100 days* Emergency department visits, number per pt per 100 days Nursing home stays Pts (%) Total days per pt per 100 days
Survived ≥1 year ECOG 0 N = 55
Survived ≥1 year ECOG ≥1 N = 51
Survived <1 year ECOG 0 N = 26
0.08 (0.16) 0.49 (1.17)
0.09 (0.19) 0.35 (0.79)
0.50 (0.70) 1.13 (1.77) 2.22 (3.45) 5.12 (8.93)
0.01 (0.05)
0.02 (0.11)
0 (0)
0.02 (0.07)
1.8% 0.04 (0.30)
5.9% 0.46 (2.01)
7.7% 1.63 (7.20)
7.4% 1.89 (9.00)
Survived <1 year ECOG ≥1 N = 68
* p < 0.001.
Disclosure: A. Tarhini: Advisory boards: Bristol-Myers Squibb, Merck, and Genentech; Corporate-sponsored research: Bristol-Myers Squibb, Merck, Novartis, Amgen, and Prometheus. A.S. Rao: Employee of Bristol-Myers Squibb. S. Corman: Employee of Pharmerit International; consulting fee or honorarium paid by Bristol-Myers Squibb to Pharmerit International. M. Botteman: employee of Pharmerit International; consulting fee from Bristol-Myers Squibb during the conduct of the study. S. Mehta: employee of Pharmerit International; consulting fee or honorarium paid by Bristol-Myers Squibb to Pharmerit International. X. Ji: employee of Pharmerit International; consulting fee or honorarium paid by Bristol-Myers Squibb to Pharmerit International. M. Katyal: Employee of Medical Data Analytics; corporate-sponsored research: Medical Data Analytics is consultant vendor to Bristol-Myers Squibb, Inc., the financial sponsor of this research study. K. Margolin: Corporate-sponsored research: GlaxoSmithKline, Bristol-Myers Squibb, Genentech, Pfizer, Altor, and Prometheus.
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HEALTHCARE RESOURCE UTILIZATION (HCRU) IN PATIENTS RECEIVING IPILIMUMAB FOR ADVANCED MELANOMA: IMPACT OF SURVIVAL AND EASTERN COOPERATIVE ONCOLOGY GROUP (ECOG) STATUS
was associated with greater HCRU only among pts surviving <1 year. Prolonged survival appears to be associated with reduced HCRU among this patient population.