Burden of chemotherapy-induced myelosuppression among patients with ES-SCLC in US community oncology settings

Future Oncol. 2022 Nov;18(35):3881-3894. doi: 10.2217/fon-2022-0754. Epub 2022 Nov 15.

Abstract

Aim: To describe the burden of chemotherapy-induced myelosuppression among chemotherapy-treated patients with extensive-stage small-cell lung cancer (ES-SCLC). Materials & methods: Occurrence of grade ≥3 myelosuppressive hematological adverse events (HAEs), treatment patterns and healthcare resource utilization (HCRU) after chemotherapy initiation were evaluated using data from The US Oncology Network and Non-network clinics (1/1/2015-12/31/2020). Results: Among patients with laboratory values (Network: N = 1,374/1,574; Non-network: N = 661/959), over half-experienced grade ≥3 HAEs after chemotherapy initiation (Network = 56.6%; Non-network = 64.1%), and approximately one-third had grade ≥3 HAEs in at least two lineages (Network = 33.0%; Non-network = 31.3%). Patients with grade ≥3 HAEs had greater dose reductions, treatment delays and HCRU than those without. Conclusion: Myelosuppression is a burden to patients with ES-SCLC treated with chemotherapy and the healthcare system.

Keywords: extensive-stage small-cell lung cancer; health care costs; health care resource utilization; myelosuppression; supportive care interventions; treatment patterns.

Plain language summary

Our objective was to describe the burden of myelosuppression, a side effect of chemotherapy that results from damage to blood-forming cells in the bone marrow, among patients with extensive-stage small-cell lung cancer (ES-SCLC). We evaluated the prevalence of myelosuppression, chemotherapy treatment patterns and outpatient healthcare use and costs after chemotherapy initiation using data from The US Oncology Network and Non-network clinics between 1 January 2015 and 31 December 2020. Among patients with laboratory values, which were required to identify myelosuppression events, over half of patients experienced severe myelosuppression-related adverse events in one or more lineages after chemotherapy initiation, and approximately one-third experienced severe myelosuppression-related adverse events in at least two blood cell lineages. Patients with severe myelosuppression-related adverse events had greater dose reductions, treatment delays, and healthcare use and costs than those without. Myelosuppression is a burden to patients with ES-SCLC treated with chemotherapy and the healthcare system. Reduction of chemotherapy-induced myelosuppression has the potential to reduce burden on patients and healthcare organizations.

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Humans
  • Lung Neoplasms* / drug therapy
  • Small Cell Lung Carcinoma* / drug therapy

Substances

  • Antineoplastic Agents

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