Glioblastoma treatment patterns, survival, and healthcare resource use in real-world clinical practice in the USA

Article Details

Authors
Allicia C Girvan, Gebra C Carter, Li Li, Anna Kaltenboeck, Jasmina Ivanova, Maria Koh, Jessi Stevens, Eleanor Hayes-Larson, Michael M Lahn

Article Type
Original Research

DOI
10.7573/dic.212274

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Abstract

Background: Glioblastoma (GB) treatment remains challenging because of recurrence and poorly defined treatment options after first-line therapy. To better understand real-world application of treatment paradigms and their impact on outcomes, we describe patterns of treatment, outcomes, and use of cancer-related healthcare resource for glioblastoma in the USA.

Methods: A retrospective, online chart-abstraction study was conducted; each participating oncologist contributed ≤5 charts. Patients were ≥18 years with biopsy-confirmed primary or secondary newly diagnosed GB on or after 1 January 2010, had received first- and second-line therapies, and had information collected for ≥3 months after initiation of second-line therapy or until death. Assessments were descriptive and included Kaplan–Meier analyses from initiation to end of second-line therapy, disease progression, or death.

Results: One hundred sixty physicians contributed information on 503 patient charts. During first-line therapy, patients most commonly underwent temozolomide monotherapy (76.5%). During second-line therapy, patients most commonly underwent bevacizumab monotherapy (58.1%). Median duration of second-line therapy was 130 days; median time to disease progression was 113 days. Median survival was 153 days. Use of supportive care was observed to be numerically higher in first- compared with second-line therapy except for anti-depressants, growth factors, and stimulants. Frequently used resources included corticosteroids (78.8% of patients in first-line and 62.6% in second-line therapies), anti-epileptics (45.8% and 41.5%) and narcotic opioids (45.3% and 41.4%).

Conclusions: Most GB patients received temozolomide during first-line therapy and bevacizumab monotherapy or combination therapy during second-line therapy. Use of supportive care appeared to be higher in first- compared with second-line therapy for some agents.

Keywords: treatment patterns, observational, bevacizumab, glioblastoma, first-line therapy, second-line therapy, cancer, temozolomide.

Abbreviations: FDA, Food and Drug Administration; GB, glioblastoma; GO Project, Glioma Outcomes Project; NCI, National Cancer Institute; NCCN, National Comprehensive Cancer Network; SD, standard deviation

Citation
Girvan AC, Carter GC, Li L, Kaltenboeck A, Ivanova J, Koh M, Stevens J, Hayes-Larson E, Lahn MM. Treatment patterns for glioblastoma, survival, and use of healthcare resources in real-world clinical practices in the USA. Drugs in Context 2015; 4: 212274. doi: 10.7573/dic.212274

Copyright
Copyright © 2015 Girvan AC, Carter GC, Li L, Kaltenboeck A, Ivanova J, Koh M, Stevens J, Hayes-Larson E, Lahn MM. Distributed under the terms of the Creative Commons License Deed CC BY NC ND 3.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution
Copyright © 2015 Girvan AC, Carter GC, Li L, Kaltenboeck A, Ivanova J, Koh M, Stevens J, Hayes-Larson E, Lahn MM. http://dx.doi.org/10.7573/dic.212274. Published by Drugs in Context under Creative Commons Attributions License Deed CC BY NC ND 3.0.

Article URL
https://www.drugsincontext.com/glioblastoma-treatment-patterns-survival-healthcare-resource-use-real-world-clinical-practice-united-states-america

Correspondence
Allicia C Girvan, PhD, Senior Research Scientist; Global Health Outcomes, Oncology; Eli Lilly and Company, 893 S. Delaware Street, Indianapolis, Indiana 46285, USA. girvan_allicia_c@lilly.com

Provenance
Submitted, externally peer reviewed

Dates
Submitted: 15 December 2014
Revised manuscript submitted: 5 February 2015
Accepted for publication: 6 February 2015
Publication date: 10 March 2015

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