525dfa2446a290a1fad44aa4c51c474a pmc_9735431.pdf d397c1235683d0b150ca778e3efb3cea6989dbea pmc_9735431.pdf 701ab9e477994aecacd94e06389d82740a8044e49e2d8a361c4e2e3d6266a8be pmc_9735431.pdf Title: Changes in Treatment Patterns and Costs for Lung Cancer Have Not Resulted in Relevant Improvements in Survival: A Population-Based Observational Study in Catalonia Subject: Objective: Few published studies have described multidisciplinary therapeutic strategies for lung cancer. This study aims to describe the different approaches used for treating lung cancer in Catalonia in 2014 and 2018 and to assess the associated cost and impact on patient survival. Methods: A retrospective observational cohort study using data of patients with lung cancer from health care registries in Catalonia was carried out. We analyzed change in treatment patterns, costs and survival according to the year of treatment initiation (2014 vs. 2018). The Kaplan–Meier method was used to estimate survival, with the follow-up until 2021. Results: From 2014 to 2018, the proportion of patients undergoing surgery increased and treatments for unresectable tumors decreased, mainly in younger patients. Immunotherapy increased by up to 9% by 2018. No differences in patient survival were observed within treatment patterns. The mean cost per patient in the first year of treatment increased from EUR 14,123 (standard deviation [SD] 4327) to EUR 14,550 (SD 3880) in surgical patients, from EUR 4655 (SD 3540) to EUR 5873 (SD 6455) in patients receiving curative radiotherapy and from EUR 4723 (SD 7003) to EUR 6458 (SD 10,116) in those treated for unresectable disease. Conclusions: From 2014 to 2018, surgical approaches increased in younger patients. The mean cost of treating patients increased, especially in pharmaceutical expenditure, mainly related to the use of several biomarker-targeted treatments. While no differences in overall patient survival were observed, it seems reasonable to expect improvements in this outcome in upcoming years as more patients receive innovative treatments. Keywords: lung cancer; real-world data; immunotherapy; targeted therapy; overall survival; cost of treatment Author: Laura Guarga, Noelia Paco, Emili Vela, Montse Clèries, Julieta Corral, Joaquim Delgadillo, Caridad Pontes and Josep Maria Borràs Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Nov 25 11:25:20 2022 CET ModDate: Fri Nov 25 11:32:59 2022 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 16 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1464553 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- TXYQVB+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 CJWQNH+VnURWPalladioL Type 1 Custom yes yes no 15 0 JRQVVC+URWPalladioL-Bold Type 1 Custom yes yes no 19 0 KQIOIV+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 PALSPG+URWPalladioL-Ital Type 1 Custom yes yes no 28 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 47 0 JGMOZW+CMSY10 Type 1 Builtin yes yes no 72 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 82 0 NPMFKK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 102 0 NPMFKL+PalatinoLinotype CID TrueType Identity-H yes yes yes 105 0 NPMFKM+PalatinoLinotype TrueType WinAnsi yes yes no 111 0 NPMFKO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 114 0 NPMHPD+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 117 0 NPMFKK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 139 0 NPMFKM+PalatinoLinotype TrueType WinAnsi yes yes no 142 0 NPMFKO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 145 0 NPMGMI+SegoeUISymbol CID TrueType Identity-H yes yes yes 148 0 NPMFKK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 165 0 NPMFKM+PalatinoLinotype TrueType WinAnsi yes yes no 168 0 NPMFKO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 171 0 NPMHPD+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 174 0 OWZLVZ+VnURWPalladioL-Italic Type 1 Custom yes yes no 192 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-08-29 02:27:39 CEST RepresentationInformation: pmc_9735431.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-08-03 02:25:24 CEST Size: 1464553 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 406 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Children: Item: Title: Data Source Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Study Population Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Outcomes Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Ethics Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Info: Title: Changes in Treatment Patterns and Costs for Lung Cancer Have Not Resulted in Relevant Improvements in Survival: A Population-Based Observational Study in Catalonia Author: Laura Guarga, Noelia Paco, Emili Vela, Montse Clèries, Julieta Corral, Joaquim Delgadillo, Caridad Pontes and Josep Maria Borràs Subject: Objective: Few published studies have described multidisciplinary therapeutic strategies for lung cancer. This study aims to describe the different approaches used for treating lung cancer in Catalonia in 2014 and 2018 and to assess the associated cost and impact on patient survival. Methods: A retrospective observational cohort study using data of patients with lung cancer from health care registries in Catalonia was carried out. We analyzed change in treatment patterns, costs and survival according to the year of treatment initiation (2014 vs. 2018). The Kaplan Meier method was used to estimate survival, with the follow-up until 2021. Results: From 2014 to 2018, the proportion of patients undergoing surgery increased and treatments for unresectable tumors decreased, mainly in younger patients. Immunotherapy increased by up to 9% by 2018. No differences in patient survival were observed within treatment patterns. The mean cost per patient in the first year of treatment increased from EUR 14,123 (standard deviation [SD] 4327) to EUR 14,550 (SD 3880) in surgical patients, from EUR 4655 (SD 3540) to EUR 5873 (SD 6455) in patients receiving curative radiotherapy and from EUR 4723 (SD 7003) to EUR 6458 (SD 10,116) in those treated for unresectable disease. Conclusions: From 2014 to 2018, surgical approaches increased in younger patients. The mean cost of treating patients increased, especially in pharmaceutical expenditure, mainly related to the use of several biomarker-targeted treatments. While no differences in overall patient survival were observed, it seems reasonable to expect improvements in this outcome in upcoming years as more patients receive innovative treatments. 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