Role of Bevacizumab in Patients With Advanced NSCLC With Liver Metastases
Posted: Monday, January 6, 2020
According to a report published in the Journal of Oncology Practice, patients with advanced non–small cell lung cancer (NSCLC) with liver metastases have poorer survival rates and higher health-care costs and resource utilization burdens than those without liver metastases. However, according to Young Kwang Chae, MD, MPH, MBA, of Northwestern University, Chicago, and colleagues, bevacizumab-containing treatment regimens appeared to provide significant survival benefits in this patient population, likely because of the characteristics of vascular endothelial growth factors and the liver tumor microenvironment.
“Liver metastasis is a negative prognostic factor in patients with NSCLC, as confirmed by real-world data,” the investigators commented. “To our knowledge, the current study is the first to demonstrate the higher cost burden and [health-care resource utilization] of liver metastasis using real-world clinical practice data.”
The investigators conducted two retrospective cohort analyses and identified patients with and without advanced NSCLC using data from an electronic health record (n = 14,209) and a claims database (n = 9,017). Those patients with baseline liver metastases were further divided into those who had versus those who had not received bevacizumab-containing therapy.
Patients with liver metastases were associated with significantly poorer survival than those without liver metastases (6.3 vs. 10.1 months; P < .01). The total per-patient health-care costs were also significantly higher ($27,589 vs. $19,607; P < .001) and were primarily driven by inpatient costs. Among patients with liver metastases, hospitalizations were twice as high, and lengths of stays were 1.7-fold higher.
Treatments that contained bevacizumab were associated with improved overall survival in all patients, including those with and without liver metastases (7.1 vs. 4.4 months; P < .01). However, the relative overall survival benefit was greater in patients with liver metastases who received bevacizumab than in those who did not (11 vs. 7.4 months; P < .01).
Disclosure: For full disclosures of the study authors, visit ascopubs.org.