{"id":2041,"date":"2022-05-13T00:00:00","date_gmt":"2022-05-13T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/utilization-of-immunotherapy-in-patients-with-cancer-treated-in-routine-care-settings-a-population-based-study-using-health-administrative-data\/"},"modified":"2023-06-14T19:30:52","modified_gmt":"2023-06-14T23:30:52","slug":"utilization-of-immunotherapy-in-patients-with-cancer-treated-in-routine-care-settings-a-population-based-study-using-health-administrative-data","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/utilization-of-immunotherapy-in-patients-with-cancer-treated-in-routine-care-settings-a-population-based-study-using-health-administrative-data\/","title":{"rendered":"Utilization of immunotherapy in patients with cancer treated in routine care settings: a population-based study using health administrative data"},"content":{"rendered":"<p><strong>Introduction<\/strong> &#x2014; The introduction of immunotherapy (IO) in the treatment of patients with cancer has significantly improved clinical outcomes. Population level information on actual IO utilization is limited.<\/p>\n<p><strong>Methods<\/strong> &#x2014; We conducted a retrospective cohort study using provincial health administrative data from Ontario, Canada to: (1) assess the extent of IO use from 2011 (pre-IO funding) to 2019; and (2) identify factors associated with IO use in patients with advanced cancers for which IO is reimbursed including melanoma, bladder, lung, head and neck, and kidney tumors. The datasets were linked using a unique encoded identifier. A Fine and Gray regression model with death as a competing risk was used to identify factors associated with IO use.<\/p>\n<p><strong>Results<\/strong> &#x2014; Among 59 510 patients assessed, 8771 (14.7%) received IO between 2011 and 2019. Use of IO increased annually from 2011 (3.3%) to 2019 (39.2%) and was highest in melanoma (52%) and lowest in head and neck cancer (6.6%). In adjusted analysis, factors associated with lower IO use included older age (hazard ratio (HR) 0.91 (95% CI, 0.89-0.93)), female sex (HR 0.85 (95% CI, 0.81-0.89)), lower-income quintile, hospital admission (HR 0.78 (95% CI, 0.75-0.82)), high Charlson score and de novo stage 4 cancer. IO use was heterogeneous across cancer centers and regions.<\/p>\n<p><strong>Conclusion<\/strong> &#x2014; IO utilization for advanced cancers rose substantially since initial approval albeit use is associated with patient characteristics and system-level factors even in a universal healthcare setting. To optimize IO utilization in routine practice, survival estimates and potential inequity in access should be further investigated and addressed.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Introduction &#x2014; The introduction of immunotherapy (IO) in the treatment of patients with cancer has significantly improved clinical outcomes. Population level information on actual IO utilization is limited. Methods &#x2014; We conducted a retrospective cohort study using provincial health administrative data from Ontario, Canada to: (1) assess the extent of IO use from 2011 (pre-IO [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-2041","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Raphael J, Richard L, Lam M, Blanchette PS, Leighl NB, Rodrigues G, Trudeau ME, Krzyzanowska MK. <em>Oncologist<\/em>. 2022; 27(8):675-84. Epub 2022 May 13.","source_url":"https:\/\/academic.oup.com\/oncolo\/advance-article\/doi\/10.1093\/oncolo\/oyac085\/6585297","ices_scientist":[1151,13132],"site":[6733],"research_program":[6741],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"44A3344F-90E3-4340-8AAC-39D247F5D588","sitecore_item_name":"Utilization-of-immunotherapy-in-patients-with-cancer-treated-in-routine-care-settings","sitecore_field_values":"{\n  \"Title\": \"Utilization of immunotherapy in patients with cancer treated in routine care settings: a population-based study using health administrative data\",\n  \"Short title\": \"Utilization of immunotherapy in patients\",\n  \"Summary\": \"The introduction of immunotherapy (IO) in treatment of patients with cancer has significantly improved clinical outcomes. This study looked at population level information on actual IO utilization.\",\n  \"Citation\": \"<p>Raphael J, Richard L, Lam M, Blanchette PS, Leighl NB, Rodrigues G, Trudeau ME, Krzyzanowska MK. <em>Oncologist<\/em>. 2022; 27(8):675-84. Epub 2022 May 13. DOI: <a href=\"https:\/\/doi.org\/10.1093\/oncolo\/oyac085\" title=\"opens external link\">https:\/\/doi.org\/10.1093\/oncolo\/oyac085<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Introduction<\/strong> &mdash; The introduction of immunotherapy (IO) in the treatment of patients with cancer has significantly improved clinical outcomes. Population level information on actual IO utilization is limited.<\/p>n<p><strong>Methods<\/strong> &mdash; We conducted a retrospective cohort study using provincial health administrative data from Ontario, Canada to: (1) assess the extent of IO use from 2011 (pre-IO funding) to 2019; and (2) identify factors associated with IO use in patients with advanced cancers for which IO is reimbursed including melanoma, bladder, lung, head and neck, and kidney tumors. The datasets were linked using a unique encoded identifier. A Fine and Gray regression model with death as a competing risk was used to identify factors associated with IO use.<\/p>n<p><strong>Results<\/strong> &mdash; Among 59 510 patients assessed, 8771 (14.7%) received IO between 2011 and 2019. Use of IO increased annually from 2011 (3.3%) to 2019 (39.2%) and was highest in melanoma (52%) and lowest in head and neck cancer (6.6%). In adjusted analysis, factors associated with lower IO use included older age (hazard ratio (HR) 0.91 (95% CI, 0.89-0.93)), female sex (HR 0.85 (95% CI, 0.81-0.89)), lower-income quintile, hospital admission (HR 0.78 (95% CI, 0.75-0.82)), high Charlson score and de novo stage 4 cancer. IO use was heterogeneous across cancer centers and regions.<\/p>n<p><strong>Conclusion<\/strong> &mdash; IO utilization for advanced cancers rose substantially since initial approval albeit use is associated with patient characteristics and system-level factors even in a universal healthcare setting. To optimize IO utilization in routine practice, survival estimates and potential inequity in access should be further investigated and addressed.<\/p>n<p><a href=\"https:\/\/academic.oup.com\/oncolo\/advance-article\/doi\/10.1093\/oncolo\/oyac085\/6585297\" title=\"opens external link\">View full text<\/a><\/p>\",\n  \"Research Programs\": \"{85DE96A6-4C96-40C7-8E6D-7597A0EB5F80}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{7ACDD626-690C-45CF-BCB3-DEC62079FEA6}|{50AE73D1-7AD4-4BCF-8129-5E0F8E219D04}\",\n  \"Posted Date\": \"20220513T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2022\/May\/Utilization-of-immunotherapy-in-patients-with-cancer-treated-in-routine-care-settings"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Utilization of immunotherapy in patients with cancer treated in routine care settings: a population-based study using health administrative data<\/title>\n<meta name=\"description\" content=\"Introduction &#x2014; 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