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| ID | Type | Description | Link |
|---|---|---|---|
| WEUKSTV3635 | Other Identifier | GSK | |
| EPI40661 | Other Identifier | GSK |
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A retrospective cohort study using the LabRx medical claims database will be performed to address these objectives. The primary objective of this project is to examine the background rates of liver function test (LFT) abnormalities in cancer patients treated with tyrosine kinase inhibitors (TKIs).
Patients were not recruited for nor enrolled in this study. This study is a retrospective observational study. Data from medical records or insurance claims databases are anonymised and used to develop a patient cohort. All diagnoses and treatment are recorded in the course of routine medical practice.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cancer patients | Adults (age ≥18 years) with at least two ICD-9 codes for a particular cancer within a 6 month timeframe and at least one code for a TKI drug that occurs on or after the first cancer diagnosis code |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tyrosine kinase inhibitors | Drug | Lapatinib, erlotinib, gefitinib, dasatinib, imatinib, nilotinib (analyzed as a class of drugs, not by individual drug) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Patients With ALT (Alanine Transaminase) >=3x (Times) Upper Limit of Normal (ULN) | Prevalence of patients with an ALT elevation >=3x ULN among patients who had liver function testing during the baseline period (30 days prior to initiation of TKI drug). | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
| Incidence of ALT >=3x ULN | Number of patients with ALT >=3 times ULN among patients with a normal ALT measurement during the baseline period (30 days prior to initiation of TKI drug). Normal is defined as an ALT <1 times ULN at baseline. | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
| Number of Hy's Law Patients (ALT or AST >= 3x ULN and ALP <2x ULN and BIL >= 2x ULN) | Prevalence of patients with Hy's Law (ALT or AST >=3x ULN and ALP <2x ULN and BIL >=2x ULN, where AST = aspartate transaminase, ALP = alkaline phosphatase, BIL= bilirubin) among patients who had liver function testing during the baseline period (30 days prior to initiation of TKI drug). | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
| Incidence of Hy's Law (ALT or AST >=3x ULN and ALP <2x ULN and BIL >=2x ULN) | Number of patients with Hy's Law (ALT or AST >= 3x ULN and ALP <2x ULN and BIL >= 2x ULN) among patients with normal ALT, AST, ALP, and BIL measurements during the baseline period (30 days prior to initiation of TKI drug). Normal is defined as an ALT AST, ALP, and BIL <1 times ULN at baseline. | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum ALT Elevation Reached During Follow-up | Number of patients whose maximum ALT elevation fell within the indicated ULN range among patients with at least one incident ALT elevation during follow-up | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
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Inclusion Criteria:
Exclusion Criteria:
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Retrospective cohort study using the LabRx medical claims EMR database. This database contains medical claims information including diagnoses, treatments, medications, and laboratory results for 23.3 million US residents. The study cohort included adult patients (age ≥18 years) with any cancer diagnosed between October 1, 2004-June 1, 2009 who were treated with 1 one or more of the TKI agents-erlotinib, gefitinib, dasatinib, imatinib, nilotinib, or lapatinib. The index date for this cohort was the date of first administration or prescription of the TKI agent on or following the date of the first cancer diagnosis.
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| Name | Affiliation | Role |
|---|---|---|
| GSK Clinical Trials | GlaxoSmithKline | Study Director |
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This observational study was conducted and supported by GlaxoSmithKline.
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| ID | Title | Description |
|---|---|---|
| FG000 | TKI Cohort | Adult (age >=18 years) members of the LabRx database (A United States healthcare claims database containing the aggregated health claims experience of the covered lives managed by United Healthcare) with at least two International Classification of Disease (ICD)-9 codes for any cancer within a six-month timeframe and at least one code for an Epidermal Growth Factor Receptor (EGFR) targeted small molecule tyrosine kinase inhibitor (TKI) drug (erlotinib, gefitinib, dasatinib, imatinib, nilotinib, and lapatinib). TKI initiation must have occurred within 30 days prior to or any time after the first cancer diagnosis. The index date was the date of the first TKI prescription, and patients were followed from 30 days prior to the index date through the last visit in the database (which may be due to death or change in health plan), or the study cut-off date of June 1, 2009, whichever came first. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | TKI Cohort | Adult (age >=18 years) members of the LabRx database (A United States healthcare claims database containing the aggregated health claims experience of the covered lives managed by United Healthcare) with at least two International Classification of Disease (ICD)-9 codes for any cancer within a six-month timeframe and at least one code for an Epidermal Growth Factor Receptor (EGFR) targeted small molecule tyrosine kinase inhibitor (TKI) drug (erlotinib, gefitinib, dasatinib, imatinib, nilotinib, and lapatinib). TKI initiation must have occurred within 30 days prior to or any time after the first cancer diagnosis. The index date was the date of the first TKI prescription, and patients were followed from 30 days prior to the index date through the last visit in the database (which may be due to death or change in health plan), or the study cut-off date of June 1, 2009, whichever came first. |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Patients With ALT (Alanine Transaminase) >=3x (Times) Upper Limit of Normal (ULN) | Prevalence of patients with an ALT elevation >=3x ULN among patients who had liver function testing during the baseline period (30 days prior to initiation of TKI drug). | Members of the TKI cohort who had liver function testing within 30 days prior to the initiation of TKI drug. | Posted | Number | participants | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
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This is a retrospective study of pre-existing medical record and/or health insurance claims data; all data are de-identified, and thus no assessments of Serious or Non-serious Adverse Events are possible.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | TKI Cohort | Adult (age >=18 years) members of the LabRx database (A United States healthcare claims database containing the aggregated health claims experience of the covered lives managed by United Healthcare) with at least two International Classification of Disease (ICD)-9 codes for any cancer within a six-month timeframe and at least one code for an Epidermal Growth Factor Receptor (EGFR) targeted small molecule tyrosine kinase inhibitor (TKI) drug (erlotinib, gefitinib, dasatinib, imatinib, nilotinib, and lapatinib). TKI initiation must have occurred within 30 days prior to or any time after the first cancer diagnosis. The index date was the date of the first TKI prescription, and patients were followed from 30 days prior to the index date through the last visit in the database (which may be due to death or change in health plan), or the study cut-off date of June 1, 2009, whichever came first. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| GSK Response Center | GlaxoSmithKline | 866-435-7343 |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D000092004 | Tyrosine Kinase Inhibitors |
| ID | Term |
|---|---|
| D047428 | Protein Kinase Inhibitors |
| D004791 | Enzyme Inhibitors |
| D045504 | Molecular Mechanisms of Pharmacological Action |
| D020228 | Pharmacologic Actions |
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| Median Time to the Maximum ALT Elevation During Follow-up |
Median time (in months) between index date and the date of maximum ALT elevation. |
| Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
| Maximum AST Elevation Reached During Follow-up | Number of patients whose maximum AST elevation fell within the indicated ULN range among patients with at least one incident AST elevation during follow-up | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
| Median Time to the Maximum AST Elevation During Follow-up | Median time (in months) between index date and date of maximum AST elevation | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
| Maximum ALP Elevation Reached During Follow-up | Number of patients whose maximum ALP elevation fell within the indicated ULN range among patients with at least one incident ALP elevation during follow-up | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
| Median Time to the Maximum ALP Elevation During Follow-up | Median time (in months) between index date and date of maximum ALP elevation | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
| Maximum BIL Elevation Reached During Follow-up | Number of patients whose maximum BIL elevations fell within the indicated ULN range among patients with at least one incident BIL elevation during follow-up | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
| Median Time to the Maximum BIL Elevation During Follow-up | Median time (in months) between index date and date of maximum BIL elevation | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
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| Sex/Gender, Customized | Number | participants |
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| Primary | Incidence of ALT >=3x ULN | Number of patients with ALT >=3 times ULN among patients with a normal ALT measurement during the baseline period (30 days prior to initiation of TKI drug). Normal is defined as an ALT <1 times ULN at baseline. | Members of the TKI cohort who had normal ALT (<1x ULN) during baseline (within 30 days prior to the initiation of TKI drug) | Posted | Number | participants | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
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| Primary | Number of Hy's Law Patients (ALT or AST >= 3x ULN and ALP <2x ULN and BIL >= 2x ULN) | Prevalence of patients with Hy's Law (ALT or AST >=3x ULN and ALP <2x ULN and BIL >=2x ULN, where AST = aspartate transaminase, ALP = alkaline phosphatase, BIL= bilirubin) among patients who had liver function testing during the baseline period (30 days prior to initiation of TKI drug). | Members of the TKI cohort who had liver function testing within 30 days prior to the initiation of TKI drug). | Posted | Number | participants | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
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| Primary | Incidence of Hy's Law (ALT or AST >=3x ULN and ALP <2x ULN and BIL >=2x ULN) | Number of patients with Hy's Law (ALT or AST >= 3x ULN and ALP <2x ULN and BIL >= 2x ULN) among patients with normal ALT, AST, ALP, and BIL measurements during the baseline period (30 days prior to initiation of TKI drug). Normal is defined as an ALT AST, ALP, and BIL <1 times ULN at baseline. | Members of the TKI cohort who had normal ALT, AST, ALP, and BIL (<1x ULN) during baseline (within 30 days prior to the initiation of TKI drug). | Posted | Number | participants | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
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| Secondary | Maximum ALT Elevation Reached During Follow-up | Number of patients whose maximum ALT elevation fell within the indicated ULN range among patients with at least one incident ALT elevation during follow-up | Members of the TKI cohort who had at least one incident ALT elevation during follow-up. | Posted | Number | participants | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
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| Secondary | Median Time to the Maximum ALT Elevation During Follow-up | Median time (in months) between index date and the date of maximum ALT elevation. | Members of the TKI cohort who had at least one incident ALT elevation during follow-up. | Posted | Median | Full Range | months | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
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| Secondary | Maximum AST Elevation Reached During Follow-up | Number of patients whose maximum AST elevation fell within the indicated ULN range among patients with at least one incident AST elevation during follow-up | Members of the TKI cohort who had at least one incident AST elevation during follow-up. | Posted | Number | participants | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
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| Secondary | Median Time to the Maximum AST Elevation During Follow-up | Median time (in months) between index date and date of maximum AST elevation | Members of the TKI cohort who had at least one incident AST elevation during follow-up. | Posted | Median | Full Range | months | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
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| Secondary | Maximum ALP Elevation Reached During Follow-up | Number of patients whose maximum ALP elevation fell within the indicated ULN range among patients with at least one incident ALP elevation during follow-up | Members of the TKI cohort who had at least one incident ALP elevation during follow-up. | Posted | Number | participants | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
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| Secondary | Median Time to the Maximum ALP Elevation During Follow-up | Median time (in months) between index date and date of maximum ALP elevation | Members of the TKI cohort who had at least one incident ALP elevation during follow-up. | Posted | Median | Full Range | months | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
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| Secondary | Maximum BIL Elevation Reached During Follow-up | Number of patients whose maximum BIL elevations fell within the indicated ULN range among patients with at least one incident BIL elevation during follow-up | Members of the TKI cohort who had at least one incident BIL elevation during follow-up. | Posted | Number | participants | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
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| Secondary | Median Time to the Maximum BIL Elevation During Follow-up | Median time (in months) between index date and date of maximum BIL elevation | Members of the TKI cohort who had at least one incident BIL elevation during follow-up. | Posted | Median | Full Range | months | Study period was October 1, 2004-June 30, 2009. Patients had at least 91 days of follow-up post index date. |
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GSK agreements may vary with individual investigators, but will not prohibit any investigator from publishing. GSK supports the publication of results from all centers of a multi-center trial but requests that reports based on single-site data not precede the primary publication of the entire clinical trial.
| D020164 | Chemical Actions and Uses |
| Title | Measurements |
|---|---|
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| ALT: >=10x ULN to <20x ULN |
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| ALT: >=20x ULN |
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| Title | Measurements |
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| ALT: >=10x ULN to <20x |
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| ALT: >=20x ULN |
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| Title | Measurements |
|---|---|
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| AST: >=10x ULN to <20x ULN |
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| AST: >=20x ULN |
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| Title | Measurements |
|---|---|
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| AST: >=10x ULN to <20x ULN |
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| AST: >=20x ULN |
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| Title | Measurements |
|---|---|
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| ALP: >=5x ULN to <10x ULN |
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| ALP: >=10x ULN |
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| Title | Measurements |
|---|---|
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| ALP: >=5x ULN to <10x ULN |
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| ALP: >=10x ULN |
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| Title | Measurements |
|---|---|
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| BIL: >=5x ULN to <10x ULN |
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| BIL: >=10x ULN |
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| Title | Measurements |
|---|---|
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| BIL: >=5x ULN to <10x ULN |
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| BIL: >=10x ULN |
|