{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:24:24Z","timestamp":1761513864520,"version":"build-2065373602"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,9,25]],"date-time":"2016-09-25T00:00:00Z","timestamp":1474761600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec><jats:title>Study Objectives<\/jats:title><jats:p>To identify subsequent therapies used after first\u2010line therapies in patients with advanced non\u2013small cell lung cancer (<jats:styled-content style=\"fixed-case\">NSCLC<\/jats:styled-content>), compare overall survival (<jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>) associated with subsequent therapies, and evaluate factors associated with <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was a retrospective cohort analysis of patients with advanced <jats:styled-content style=\"fixed-case\">NSCLC<\/jats:styled-content> (stage <jats:styled-content style=\"fixed-case\">IIIB<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>) who were initiated on first\u2010line therapy from January 1, 2008, through September 30, 2013, and afterward given subsequent chemotherapy (index date). Patients had to be 18 years or older at the time of diagnosis of advanced <jats:styled-content style=\"fixed-case\">NSCLC<\/jats:styled-content>. Patients were followed from the index date until one of the following end points: end of the study (September 30, 2014), disenrollment from the health plan, or death\u2014whichever came the earliest. The primary outcome was <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>. Kaplan\u2010Meier curves and Cox proportional hazard models were used to analyze <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> and evaluate the factors associated with <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analysis included 1280 patients on subsequent therapies. The most common subsequent therapies were pemetrexed (284 patients [22%]), erlotinib (216 patients [17%]), and docetaxel (139 patients [11%]). Patients from the singlets group had a lower <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> at 6.3 months compared with all other groups: pemetrexed based, combination of pemetrexed and bevacizumab based, bevacizumab based, doublets, and tyrosine kinase inhibitors (p&lt;0.0001). Factors associated with greater <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> included age younger than 65 years, female gender, and a longer time between initiation of first and subsequent therapies. Factors associated with a reduction in <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> were pemetrexed\u2010based or singlet regimens for subsequent therapy, diagnosis of squamous histology, and a higher number of adverse events prior to subsequent therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found that a subsequent therapy consisting of singlets is associated with reduced <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> compared with other chemotherapy groups. Patient characteristics such as female gender, age younger than 65 years, diagnosis of nonsquamous histology, and\/or a longer time frame between initiation of first\u2010line and subsequent chemotherapy are associated with longer survival.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.1826","type":"journal-article","created":{"date-parts":[[2016,8,13]],"date-time":"2016-08-13T10:29:02Z","timestamp":1471084142000},"page":"1065-1074","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Identifying Subsequent Therapies in Patients with Advanced Non\u2013Small Cell Lung Cancer and Factors Associated with Overall Survival"],"prefix":"10.1002","volume":"36","author":[{"given":"Janna","family":"Afanasjeva","sequence":"first","affiliation":[{"name":"Drug Information Group University of Illinois\u2010Chicago, College of Pharmacy Chicago Illinois"},{"name":"Drug Information Services Kaiser Permanente Oakland California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita L.","family":"Hui","sequence":"additional","affiliation":[{"name":"Pharmacy Outcomes Research Group Kaiser Permanente Oakland California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele M.","family":"Spence","sequence":"additional","affiliation":[{"name":"Pharmacy Outcomes Research Group Kaiser Permanente Oakland California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Chang","sequence":"additional","affiliation":[{"name":"Drug Information Services Kaiser Permanente Oakland California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne E.","family":"Schottinger","sequence":"additional","affiliation":[{"name":"Southern California Kaiser Permanente Medical Group Pasadena California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirta","family":"Millares","sequence":"additional","affiliation":[{"name":"Drug Information Services Kaiser Permanente Oakland California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nazia","family":"Rashid","sequence":"additional","affiliation":[{"name":"Pharmacy Outcomes Research Group Kaiser Permanente Oakland California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,9,25]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"SEER stat fact sheets: cancer of any site.Bethesda MD:National Cancer Institute. Available fromhttp:\/\/seer.cancer.gov\/statfacts\/html\/all.html. Accessed May 20 2016."},{"key":"e_1_2_7_3_1","unstructured":"SEER stat fact sheets: lung and bronchus cancer.Bethesda MD:National Cancer Institute. Available fromhttp:\/\/seer.cancer.gov\/statfacts\/html\/lungb.html. Accessed May 20 2016."},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0802714"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61502-0"},{"key":"e_1_2_7_6_1","unstructured":"National Comprehensive Cancer Network clinical practice guideline in oncology: non\u2010small cell lung cancer. National Comprehensive Cancer Network. Available fromhttps:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/nscl.pdf. Updated January 12 2016. Accessed May 20 2016."},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3816\/CLC.2010.n.049"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2013-0096"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.2174\/157488711793980192"},{"issue":"1","key":"e_1_2_7_10_1","first-page":"49","article-title":"Milestones in the use of chemotherapy for the management of non\u2010small cell lung cancer (NSCLC)","volume":"81","author":"Klastersky J","year":"2012","journal-title":"Crit Rev Oncol Hematol"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.34.2774"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2012.703133"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2010.525489"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-1503"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e3182307f33"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2013.09.018"},{"key":"e_1_2_7_17_1","unstructured":"Fast facts about Kaiser Permanente. Kaiser Permanente website. Available fromhttp:\/\/share.kaiserpermanente.org\/article\/fast-facts-about-kaiser-permanente\/. Updated May 25 2016. Accessed June 6 2016."},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2007.03.011"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.10.2095"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdl454"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2009.12.013"},{"issue":"18","key":"e_1_2_7_22_1","first-page":"374s","article-title":"Analysis of prognostic factors in patients with advanced relapsed\/refractory NSCLC: Cox regression analysis of a randomized phase III trial comparing docetaxel and paclitaxel poliglumex (PPX)","volume":"24","author":"Bonomi PLC","year":"2006","journal-title":"J Clin Oncol"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(11)70172-1"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2008-0232"},{"key":"e_1_2_7_25_1","unstructured":"LetterRJ.Food and Drug Administration website. Available fromhttp:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/appletter\/2008\/021462s015ltr.pdf. Updated September 2008. Accessed May 25 2016."},{"key":"e_1_2_7_26_1","unstructured":"Alimta \u2013 pemetrexed [package insert].Indianapolis IN:Eli Lilly and Company; September2007."}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fphar.1826","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.1826","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T14:50:10Z","timestamp":1761058210000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.1826"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9,25]]},"references-count":25,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2016,10]]}},"alternative-id":["10.1002\/phar.1826"],"URL":"https:\/\/doi.org\/10.1002\/phar.1826","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"type":"print","value":"0277-0008"},{"type":"electronic","value":"1875-9114"}],"subject":[],"published":{"date-parts":[[2016,9,25]]},"assertion":[{"value":"2016-09-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}