Health care contact days after second-line systemic therapy in patients with advanced non-small cell lung cancer in Japan with or without subsequent systemic therapy.

INTRODUCTION

Evidence-based systemic therapy for advanced non-small cell lung cancer (NSCLC) is established only up to the second line; the value of subsequent systemic therapy (SST) remains unclear. For patients with a limited prognosis, not only survival but also how they spend that time is important. Health care contact days have emerged as a patient-centered measure of time spent receiving care. However, the impact of SST on health care contact days has not been evaluated.

MATERIALS AND

METHODS

We conducted a retrospective cohort study using claims data from Kyoto Prefecture, Japan (April 2013-March 2023). Patients with advanced NSCLC who completed first- and second-line systemic therapy were classified into an SST group or a no SST group. The primary outcome was health care contact days after second-line treatment. Secondary outcomes included overall survival (OS) and the health care contact days/OS ratio.

RESULTS

Of 616 patients, 411 (66.7%) received SST and 205 (33.3%) did not. Patients who received SST accumulated significantly more health care contact days than those who did not (89 vs. 69 days, P < 0.001). No significant differences were observed in OS (347 vs. 287 days; HR 0.92; 95% CI 0.75-1.13) or the health care contact days/OS ratio (0.31 vs. 0.30, P = 0.55). Among patients aged 80-89 years, the ratio was significantly higher in the SST group.

DISCUSSION: Health care contact days provided information complementary to survival and should be considered alongside survival when evaluating SST.