Abstract 1213: Comorbidities and concomitant medication use in small cell lung cancer patients treated with third and later-lines of therapy: An analysis of electronic health records data
Authors: Jiang Rui , Gulbranson Scott H. , Komarnitsky Philip , Lievano Fabio A. , Koch Martina M. , Papademetriou Eros , Tyczynski Jerzy E. 
Published: August 2018

Recent real-world data on comorbidities and concomitant medications in SCLC patients are scarce, particularly for later-lines of treatment. The purpose of this study was to describe comorbidities' pattern and concomitant medication use in SCLC patients who received third- and later-lines of therapy (LOT). We conducted an analysis of 8,291 patients with newly diagnosed SCLC between 01/01/2008 and 09/30/2016 using Optum's electronic health records (EHR) database. The database consists of de-identified EHR data from a network of health care provider organizations in the United States. Of the 8,291 SCLC patients followed longitudinally, 428 received 3rd LOT. 206 LOTs were 4th or later-lines. At start of 3rd LOT, median age was 65, 46% were male, 97% had extensive disease (excluding n=52 with missing staging). The most prevalent comorbidities by the Charlson Comorbidity Index (CCI) category in SCLC patients during 6 months before start of 3rd LOT were metastatic solid tumor, chronic pulmonary disease, cardiovascular disease, and diabetes (top 10 are listed in Table 1). The frequently prescribed concomitant medications in SCLC patients within 6 month after start of 3rd LOT include analgesics, systemic corticosteroids, drugs for gastrointestinal complaints, anxiolytics, respiratory agents, antihypertensives and other cardiovascular agents, antidiabetics, and anti-infectives (top 10 are listed in Table 1). The patterns of comorbidities and concomitant medications were similar between 3rd LOT and 4th+ LOTs (4th+ LOT data not shown). In conclusion, this analysis provides unique real-world comorbidity and concomitant medication data in SCLC with 3rd and later-lines of therapy. These patients are mostly prescribed with medications for pain and inflammation due to the ongoing disease. Comorbidity conditions that are common in older adults are also observed in SCLC patients receiving later-lines therapy.

Table 1. Top 10 comorbidities by Charlson Comorbidity Index (CCI) and top 10 concomitant medicationsCCIPercentage (%), n=428Metastatic solid tumor76.4Chronic pulmonary disease47.4Diabetes21.5Mild liver disease21.3Peripheral vascular disease16.1Cerebrovascular disease11.2Renal disease7.7Congestive heart failure6.8Myocardial infarction5.1Diabetes with chronic complications4.0Drug ClassNarcotic analgesics79.4Glucocorticoids72.2Intravenous supplies69.95-hydroxytryptamine-3 antagonists (antiemetic agent)69.6Heparins or glycosaminoglycans58.2Anxiolytics57.5Antidopaminergics (antiemetic agents)53.0Antihistamines (sedating)45.6Acetaminophen and proton pump inhibitors44.4Intravenous nutritional therapy; electrolyte; trace element; metal; vitamin; alone or combinations39.7

Citation Format: Rui Jiang, Scott H. Gulbranson, Philip Komarnitsky, Fabio A. Lievano, Martina M. Koch, Eros Papademetriou, Jerzy E. Tyczynski. Comorbidities and concomitant medication use in small cell lung cancer patients treated with third and later-lines of therapy: An analysis of electronic health records data [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1213.