Real-world treatment patterns of gastrointestinal neuroendocrine tumors

A claims database analysis

Al B Benson III, Michael S. Broder, Beilei Cai, Eunice Chang, Maureen P. Neary, Elya Papoyan

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

AIM To describe real-world treatment patterns of gastrointestinal neuroendocrine tumors (GI NET). METHODS In this retrospective cohort study, we used 2009-2014 data from 2 United States commercial claims databases to examine newly pharmacologically treated patients using tabular and graphical techniques. Treatments included somatostatin analogues (SSA), cytotoxic chemotherapy (CC), targeted therapy (TT), interferon(IF) and combinations. We identified patients at least 18 years of age, with ≥ 1 inpatient or ≥ 2 outpatient claims for GI NET who initiated pharmacologic treatment from 7/1/09-6/30/14. A 6 mo clean period prior to first treatment ensured patients were newly treated. Patients were followed until end of enrollment or the study end date, whichever was first. RESULTS We identified 2258 newly treated GI NET patients: mean (SD) age was 55.6 years (SD = 9.7), 47.2% of the patients were between 55 and 64 years, and 48.8% were female. All regions of the United States were represented. 59.6% started first-line therapy with SSA monotherapy (964 with octreotide LAR, 380 with octreotide SA, and 1 with lanreotide), 33.3% CC, 3.6% TT, and 0.5% IF. The remainder received combinations. Mean follow up was 576 d. Overall mean first-line therapy duration was 361 d (449 d for SSA, 215 for CC, 267 for TT). 58.9% of patients had no pharmacological treatment beyond first line. The most common secondline was combination therapy with SSA. In graphical pattern analysis, there was no clear pattern visible after first line therapy. CONCLUSION In this study, 60% of patients initiated treatment with SSA alone or in combination. The relatively long time to discontinuation suggests possible sustained effectiveness and tolerability.

Original languageEnglish (US)
Pages (from-to)6128-6136
Number of pages9
JournalWorld Journal of Gastroenterology
Volume23
Issue number33
DOIs
StatePublished - Sep 7 2017

Fingerprint

Insurance Claim Review
Neuroendocrine Tumors
Databases
Somatostatin
Therapeutics
Octreotide
Drug Therapy
Interferons

Keywords

  • Chemotherapy
  • Gastrointestinal neuroendocrine tumors
  • Insurance claims
  • Somatostatin analogue
  • Targeted therapy
  • Treatment patterns

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Benson III, Al B ; Broder, Michael S. ; Cai, Beilei ; Chang, Eunice ; Neary, Maureen P. ; Papoyan, Elya. / Real-world treatment patterns of gastrointestinal neuroendocrine tumors : A claims database analysis. In: World Journal of Gastroenterology. 2017 ; Vol. 23, No. 33. pp. 6128-6136.
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title = "Real-world treatment patterns of gastrointestinal neuroendocrine tumors: A claims database analysis",
abstract = "AIM To describe real-world treatment patterns of gastrointestinal neuroendocrine tumors (GI NET). METHODS In this retrospective cohort study, we used 2009-2014 data from 2 United States commercial claims databases to examine newly pharmacologically treated patients using tabular and graphical techniques. Treatments included somatostatin analogues (SSA), cytotoxic chemotherapy (CC), targeted therapy (TT), interferon(IF) and combinations. We identified patients at least 18 years of age, with ≥ 1 inpatient or ≥ 2 outpatient claims for GI NET who initiated pharmacologic treatment from 7/1/09-6/30/14. A 6 mo clean period prior to first treatment ensured patients were newly treated. Patients were followed until end of enrollment or the study end date, whichever was first. RESULTS We identified 2258 newly treated GI NET patients: mean (SD) age was 55.6 years (SD = 9.7), 47.2{\%} of the patients were between 55 and 64 years, and 48.8{\%} were female. All regions of the United States were represented. 59.6{\%} started first-line therapy with SSA monotherapy (964 with octreotide LAR, 380 with octreotide SA, and 1 with lanreotide), 33.3{\%} CC, 3.6{\%} TT, and 0.5{\%} IF. The remainder received combinations. Mean follow up was 576 d. Overall mean first-line therapy duration was 361 d (449 d for SSA, 215 for CC, 267 for TT). 58.9{\%} of patients had no pharmacological treatment beyond first line. The most common secondline was combination therapy with SSA. In graphical pattern analysis, there was no clear pattern visible after first line therapy. CONCLUSION In this study, 60{\%} of patients initiated treatment with SSA alone or in combination. The relatively long time to discontinuation suggests possible sustained effectiveness and tolerability.",
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Real-world treatment patterns of gastrointestinal neuroendocrine tumors : A claims database analysis. / Benson III, Al B; Broder, Michael S.; Cai, Beilei; Chang, Eunice; Neary, Maureen P.; Papoyan, Elya.

In: World Journal of Gastroenterology, Vol. 23, No. 33, 07.09.2017, p. 6128-6136.

Research output: Contribution to journalArticle

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T1 - Real-world treatment patterns of gastrointestinal neuroendocrine tumors

T2 - A claims database analysis

AU - Benson III, Al B

AU - Broder, Michael S.

AU - Cai, Beilei

AU - Chang, Eunice

AU - Neary, Maureen P.

AU - Papoyan, Elya

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N2 - AIM To describe real-world treatment patterns of gastrointestinal neuroendocrine tumors (GI NET). METHODS In this retrospective cohort study, we used 2009-2014 data from 2 United States commercial claims databases to examine newly pharmacologically treated patients using tabular and graphical techniques. Treatments included somatostatin analogues (SSA), cytotoxic chemotherapy (CC), targeted therapy (TT), interferon(IF) and combinations. We identified patients at least 18 years of age, with ≥ 1 inpatient or ≥ 2 outpatient claims for GI NET who initiated pharmacologic treatment from 7/1/09-6/30/14. A 6 mo clean period prior to first treatment ensured patients were newly treated. Patients were followed until end of enrollment or the study end date, whichever was first. RESULTS We identified 2258 newly treated GI NET patients: mean (SD) age was 55.6 years (SD = 9.7), 47.2% of the patients were between 55 and 64 years, and 48.8% were female. All regions of the United States were represented. 59.6% started first-line therapy with SSA monotherapy (964 with octreotide LAR, 380 with octreotide SA, and 1 with lanreotide), 33.3% CC, 3.6% TT, and 0.5% IF. The remainder received combinations. Mean follow up was 576 d. Overall mean first-line therapy duration was 361 d (449 d for SSA, 215 for CC, 267 for TT). 58.9% of patients had no pharmacological treatment beyond first line. The most common secondline was combination therapy with SSA. In graphical pattern analysis, there was no clear pattern visible after first line therapy. CONCLUSION In this study, 60% of patients initiated treatment with SSA alone or in combination. The relatively long time to discontinuation suggests possible sustained effectiveness and tolerability.

AB - AIM To describe real-world treatment patterns of gastrointestinal neuroendocrine tumors (GI NET). METHODS In this retrospective cohort study, we used 2009-2014 data from 2 United States commercial claims databases to examine newly pharmacologically treated patients using tabular and graphical techniques. Treatments included somatostatin analogues (SSA), cytotoxic chemotherapy (CC), targeted therapy (TT), interferon(IF) and combinations. We identified patients at least 18 years of age, with ≥ 1 inpatient or ≥ 2 outpatient claims for GI NET who initiated pharmacologic treatment from 7/1/09-6/30/14. A 6 mo clean period prior to first treatment ensured patients were newly treated. Patients were followed until end of enrollment or the study end date, whichever was first. RESULTS We identified 2258 newly treated GI NET patients: mean (SD) age was 55.6 years (SD = 9.7), 47.2% of the patients were between 55 and 64 years, and 48.8% were female. All regions of the United States were represented. 59.6% started first-line therapy with SSA monotherapy (964 with octreotide LAR, 380 with octreotide SA, and 1 with lanreotide), 33.3% CC, 3.6% TT, and 0.5% IF. The remainder received combinations. Mean follow up was 576 d. Overall mean first-line therapy duration was 361 d (449 d for SSA, 215 for CC, 267 for TT). 58.9% of patients had no pharmacological treatment beyond first line. The most common secondline was combination therapy with SSA. In graphical pattern analysis, there was no clear pattern visible after first line therapy. CONCLUSION In this study, 60% of patients initiated treatment with SSA alone or in combination. The relatively long time to discontinuation suggests possible sustained effectiveness and tolerability.

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