Streamlining NSCLC Patient Identification

Healthcare Resource Utilization Of ROS1+ Non-Small Cell Lung Cancer Patients Treated With Tyrosine Kinase Inhibitors 

This poster was originally presented at ISPOR Europe, November 6-9, 2022, in Vienna, Austria.  

Authors: Andrew Shim, A. Singhania, Dave Iwanyckyj, F. Otalora, B. Morrison, SW Wade 

Affiliations: Turning Point Therapeutics, San Diego, CA, USA; Amplity, Bucks, UK; Wade Outcomes Research and Consulting, Salt Lake City, UT, USA 

Introduction 

This exploratory analysis examined the unexpected healthcare resource utilization (HCRU) of ROS1+ non-small cell lung cancer (NSCLC) patients using data from physician narratives of real-world patient encounters in the U.S. routine care setting. 

Methods  

• Data Source: Amplity AnswerY™ (formerly known as Amplity Insights™) real-world database (at time of study) of HIPAA-compliant transcriptions of U.S.  prescriber–patient visits from January 2015 through November 2021: 

• 50 million electronic medical transcription records from >150,000 multi-specialty providers at approximately 40,000 inpatient/outpatient care sites across 50 states and 2 US territories. 

• All payers: Medicare, Commercial, Medicaid, Uninsured, and Self-Pay. 

• Study population: Adults (age >18 years) ROS1+ NSCLC patients treated with crizotinib, entrectinib, ceritinib, and/or lorlatinib. 

Results 

• As shown in Figure 1, 103 ROS1+ NSCLC patients were identified; 25 used TKI in any line. The low number of patients identified is consistent with rare nature of ROS1 driver mutation in NSCLC.  

• 23 patients used crizotinib, 4 used lorlatinib, 4 used ceritinib, and 2 used entrectinib. 

According to Figure 2: 

• Majority of TKI-treated ROS1+ NSCLC patients (68%) experienced a major or minor health care resource utilization (HCRU) event.  

• 35% experienced a MAJOR † HCRU event associated with or while on TKI treatment such as unscheduled visit to Emergency Room (ER) or an unscheduled visit to the clinic.  

• 38% experienced a MINOR ‡ HCRU event such as symptomatic management of an adverse event with a prescription medication or a new/recurring laboratory test. 

According to Figure 3, among patients who had a major HCRU event mentioned:  

• 6 patients required specialist consults/evaluations due to adverse effect or toxicity (Ophthalmology, Cardiovascular, or Gastroenterology) 

• 5 patients had unplanned hospital/floor admission, ER, or clinic visit  

• 2 patients received a new diagnosis potentially-related to TKI toxicity  

According to Figure 4, among patients who had a minor HCRU event mentioned: 

• 3 patients required either oxygen or IV fluid administration 

• 2 patients underwent regularly scheduled lab tests 

• 4 patients required the use of antiemetics for nausea/vomiting 

Conclusions 

• Research based on transcription notes in AnswerY found that the majority (68%) of all patients experienced an HCRU event. 

• 35% experienced major events and 38% experienced minor events.  

• The most common major events were consults/referrals to specialists, unscheduled visit to ER/clinic, and admittance to hospital.  

• 61% of crizotinib (14 of 23), 67% of entrectinib (2 of 3), 20% of lorlatinib (1 of 5), and 25% of ceritinib (1 of 4) patients had major or minor HCRU events mentioned in their transcription medical records.  

• Unexpected HCRU events among ROS1+ NSCLC patients treated with crizotinib or other available TKIs may contribute to the total cost of care and should be considered as a relevant and significant additional burden of managing this diagnosis with the current treatment options. 

DOWNLOAD POSTER 

AnswerY gets to the “why” behind prescriber rationale. See other NSCLC-related research.