摘要 : PLAIN LANGUAGE SUMMARY Neuroendocrine neoplasms (NENs) are uncommon cancers involving the body's neuroendocrine cells. One type of NEN that is less aggressive with more favorable characteristics and prognosis is known as neuroendo... 展开 PLAIN LANGUAGE SUMMARY Neuroendocrine neoplasms (NENs) are uncommon cancers involving the body's neuroendocrine cells. One type of NEN that is less aggressive with more favorable characteristics and prognosis is known as neuroendocrine tumor (NET). Somatostatin receptors (SSTR) are expressed by most NETs and are important treatment targets. Two-thirds of NETs originate in the body's gastroenteropancreatic system (GEP-NETs). GEP-NET is typically treated in the first instance with somatostatin analogs (SSAs), while other treatments such as chemotherapy, biologic targeted therapy, or Radio Ligand Therapy (RLT), can be offered to patients who have progressed. [Lu-177]Lu-DOTA-TATE is a form of RLT that has recently been approved for use in England, Wales, and Scotland. The purpose of this study is to analyze the utilization of healthcare resources and the costs associated with the management of GEP-NETs patients who have progressed on SSAs. This study is based on hospital data from England as available in the Hospital Episode Statistics dataset 2016-2018. The utilization and costs of healthcare resources were compared between two groups of patients. Following progression, one group received [Lu-177]Lu-DOTA-TATE, while the other group received other therapies (chemotherapy, biologic targeted therapy, or SSA with escalated or more frequent dosing). Statistical techniques were applied to enhance the comparability of analyzed groups of patients. The results revealed that the [Lu-177]Lu-DOTA-TATE group had lower inpatient admissions, outpatient appointments, and Accident & Emergency attendances compared with the non-[Lu-177]Lu-DOTA-TATE group. Furthermore, the overall costs in the [Lu-177]Lu-DOTA-TATE group were lower by 37.6%. This study indicated that patients and hospitals in England and other parts of the United Kingdom may benefit from the use of [Lu-177]Lu-DOTA-TATE. Further research is foreseen involving additional and linked databases, including further clinical outcomes as well. Objective To explore the healthcare resource utilization (HCRU) and costs for patients with progressive gastroenteropancreatic neuroendocrine tumors (GEP-NETs) treated with [Lu-177]Lu-DOTA-TATE and matched patients treated with somatostatin analogs (SSAs), chemotherapy, or targeted therapies. Methods Hospital Episode Statistics (HES) dataset 2016-2018 was used to compare HCRU and costs between the two cohorts. The [Lu-177]Lu-DOTA-TATE cohort included patients assigned with a diagnosis code relevant to GEP-NET, a procedure code for imaging or SSAs, and a subsequent code for radionuclide therapy. The non-[Lu-177]Lu-DOTA-TATE cohort included patients assigned with a diagnosis code relevant to GEP-NET who had an increased frequency of SSAs or switched from SSAs to chemotherapy or targeted therapies. Cohorts were matched on propensity scores with sex, age at disease progression, and Charlson Comorbidity Index as parameters. Healthcare Resource Group codes were used for costing. Results A total of 199 matched patients were included. The [Lu-177]Lu-DOTA-TATE cohort had lower overall costs (1,882,028 pound vs. 3,016,321; pound p < .0001), non-elective inpatient spells (289 vs. 611 days) and costs (849,569 pound vs. 1,707,109; pound p < .0001 for both), Accident & Emergency costs (41,978 pound vs. 62,480; pound p = .0013), and average length of stay for overall inpatient spells (14.2 vs. 23.3 days; p = .1092) compared with the non-[Lu-177]Lu-DOTA-TATE cohort. Conclusions These analyses indicate significantly lower overall costs and HCRU for progressive GEP-NET patients treated with [Lu-177]Lu-DOTA-TATE. Current research reveals that future real-world analyses would further benefit from using additional databases linked to the HES dataset such as the Clinical Practice Research Datalink and/or National Cancer Registration and Analysis Service database. 收起