Incidence of cachexia and health resource use (HRU) in patients with breast, colorectal, lung, pancreatic, and prostate cancers

BackgroundThe incidence and economic burden of cancer cachexia are not well described. Study objective: estimate cachexia incidence and compare HRU in patients with solid tumors with and without cachexia.MethodsThis retrospective study was conducted using the Optum Market Clarity database. Patients had breast, colorectal, lung, pancreatic, or prostate cancer between 10/1/2016-9/30/2022 and ≥2 weight measurements 150-210 days apart with ≥1 measurement after cancer index date. Cachexia cases had ≥5% weight loss between measurements (Fearon criteria); date of second measurement was designated the cachexia index date. Controls had <5% weight loss; index dates imputed as the second of 2 weight measurements 150-210 days apart. Inverse probability of treatment weights were used to balance both groups at cachexia index date. Primary outcome: number of healthcare visits/patient/month (PPPM) during the 12 months after cachexia index date, categorized as hospital inpatient (IP) admissions, hospital outpatient (OP), office, home/telehealth, and other visits. T-tests were used to compare HRU in cachexia cases vs controls by tumor type.Results27679 patients with breast (N=9660), colorectal (N=3080), lung (N=3116), pancreatic (N=449), or prostate (N=8650) cancer were included. 12 months after cancer diagnosis, 34%, 51%, 55%, 73%, and 29% of patients, respectively, had cachexia. Across tumor types, significantly more hospital OP visits PPPM occurred in cachexia vs controls (Table). Differences in hospital IP, office, home/telehealth, and other visits were observed, with statistical significance varying by tumor type. Table: 1822P PPPM claims by tumor type in cachexia cases vs controls Breast Colorectal Lung Pancreatic Prostate Cachexia Cases (n=3289) Controls (n=6371) p Cachexia Cases (n=1576) Controls (n=1504) p Cachexia Cases (n=1725) Controls (n=1391) p Cachexia Cases (n=326) Controls (n=123) p Cachexia Cases (n=2536) Controls (n=6114) p Hospital IP 0.57 0.49 .197 1.71 1.42 .190 4.10 3.48 .164 5.10 7.01 .236 0.90 0.41 <.0001 Hospital OP 2.74 1.93 <.0001 2.87 1.89 <.0001 4.53 3.35 <.0001 5.85 3.62 .022 1.87 1.51 <.0001 Office 3.20 2.90 .001 3.75 3.03 <.0001 3.85 3.87 .894 5.72 2.24 <.0001 2.87 2.60 .001 Home/telehealth 0.60 0.69 .178 1.20 0.72 <.0001 1.68 1.63 .739 2.09 1.06 .028 0.53 0.36 .001 Other 1.27 1.16 .080 1.89 1.52 .006 2.60 2.18 .009 3.15 3.19 .941 1.35 1.01 <.0001 ConclusionsIncidence of cachexia was highest in pancreatic followed by lung and colorectal, and lowest in breast and prostate cancers. Patients with cachexia used more health resources than controls, collectively highlighting clinical and economic burden in this population.Legal entity responsible for the studyPfizer.FundingPfizer.DisclosureI. Ali: Financial Interests, Personal, Full or part-time Employment: Icahn School of Medicine at Mount Sinai. S. Dagenais,I. Jacobs, F. Dai, O. Dina: Financial Interests, Personal, Full or part-time Employment: Pfizer; Financial Interests, Personal, Stocks/Shares: Pfizer. S. Corman, T. Adesoba: Financial Interests, Personal, Full or part-time Employment: PRECISIONheor; Financial Interests, Institutional, Other, Consulting fees to PRECISIONheor: Pfizer.