Supportive Care in Cancer Use of Prophylactic Growth Factors and Antimicrobials in Elderly Patients with Cancer: A Systematic Review of the Medicare Database Romina Sosa, Shuling Li, Julia T. Molony, Jiannong Liu, Scott Stryker, Allan J. Collins Corresponding Author Allan J Collins, MD, FACP Chronic Disease Research Group, Minneapolis Medical Research Foundation ACollins@cdrg.org
Supplementary Table S1. Administrative codes used to identify chemotherapy Type of Codes Codes ICD-9-CM procedure codes for 99.25 administration CPT codes for administration 96400-96549 excluding 96402 HCPCS codes for administration C8953-C8955, G0355-G0362 excluding G0356, G3001, Q0083-Q0085 ICD-9-CM diagnosis code V58.1, V66.2, V67.2 Revenue codes 0331, 0332, 0335 DRG codes 410 and 492 on inpatient claims with discharge date before October 1, 2007; 846-848 and 837-839 on inpatient claims with discharge date on or after October 1, 2007 HCPCS codes for chemotherapeutic A9522, A9523, A9534, A9542-A9545, C1081, C1083, agents * C1166, C1167, C1178, C9017, C9110, C9117, C9118, C9127, C9205, C9213-C9215, C9253, C9257, C9259, C9260, C9265, C9414, C9415, C9417-C9429, C9431- C9433, C9437, C9439, C9440, J0594, J7527,, J8510, J8520, J8521, J8530, J8560-J8562, J8565, J8600, J8610, J8700, J8705, J9000-J9999 (excluding J9155, J9202, J9212, J9215-J9219, J9225, J9226, J9395), Q2017, Q2024, Q2025, Q2049, S0116, S0172, S0178, S0182 CPT, Current Procedural Terminology; DRG, diagnosis-related group; HCPCS, Healthcare Common Procedure Coding System; ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification. * Includes Aldesleukin, Alemtuzumab, Arsenic trioxide, Asparaginase (erwinaze), Azacitidine, BCG (intravesical) per instillation, Bendamustine, Bevacizumab (Avastin), Bleomycin, Bortezomib, Brentuximab vedotin, Busulfan, Cabazitaxel, Capecitabine, Carboplatin, Carmustine, Cetuximab, Chlorambucil (Leukeran), Cisplatin, Cladribine, Clofarabine, Cyclophosphamide, Cytarabine liposome, Dacarbazine, Dactinomycin, Daunorubicin, Denileukin diftitox, Diethylstilbestrol diphosphate, Docetaxel, Doxorubicin, Elliotts b solution, Epirubicin, Eribulin mesylate, Etoposide, Everolimus, Floxuridine, Fludarabine, Fluorouracil, Gefitinib, Gemcitabine, Gemtuzumab ozogamicin, Ibritumomab tiuxetan (Zevalin), Idarubicin,
Ifosfamide, Interferon alfa-2a and alfa-2b, Ipilimumab, Irinotecan, Ixabepilone, Lomustine, Mechlorethamine, Melphalan, Mesna, Methotrexate, Mitomycin, Mitoxantrone, Nelarabine, Ofatumumab, Oxaliplatin, Paclitaxel, Panitumumab, Pegaspargase, Pemetrexed, Pentostatin, Plicamycin, Porfimer sodium, Pralatrexate, Procarbazine hydrochloride, Rituximab, Romidepsin, Streptozocin, Temozolomide, Temsirolimus, Teniposide, Thiotepa, Topotecan, Tositumomab (Bexxar), Trastuzumab, Valrubicin, Vinblastine, Vincristine, and Vinorelbine.
Supplementary Table S2. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes used to define comorbid conditions Comorbid Conditions ICD-9-CM Diagnosis Codes Chronic kidney disease 016.0, 095.4, 189.0, 189.9, 223.0, 236.91, 250.4, 271.4, 274.1, 283.11, 403.X1, 404.X2, 404.X3, 440.1, 442.1, 447.3, 572.4, 580-588, 591, 642.1, 646.2, 753.12-753.17, 753.19, 753.2, and 794.4 Atherosclerotic heart disease 410-414, V45.18, and V45.82 Cerebrovascular accidents/transient 430-438 ischemic attacks Chronic obstructive pulmonary disease 491.xx-494.xx, 496.xx, 510.xx Congestive heart failure 398.91, 422.xx, 425.xx, 428.xx, 402.x1, 404.x1, 404.x3, V42.1 Diabetes mellitus 250.xx, 357.2, 362.0x, 366.41 Dysrhythmia 426.xx-427.xx, V45.0, and V53.3 Gastrointestinal disorders 456.0-456.2, 530.7, 531.xx-534.xx, 569.84, 569.85, 578 Liver disease 570.xx, 571.xx, 572.1, 572.4, 573.1-573.3, V42.7, Other cardiovascular disease 420.xx-421.xx, 423.xx-424.xx, 429.xx, 785.0-785.3, V42.2, and V43.3 Peripheral vascular disease 440-444; 447; 451-453; 557 Anemia 280-285 HIV infection 042, 079.53 Thyroid disease 240.x-246.x Peptic ulcer disease 531.x-539.x Rheumatoid disease (rheumatoid arthritis) 714.x Osteoarthritis 715.x Other cancer 140-172; 174-208; (excluding 173-174 for breast cancer, 162-163 for lung cancer, and 200 and 202 for non-hodgkin lymphoma)
Supplementary Table S3. List of oral antimicrobial agents Antimicrobial Class Antibacterials Penicillins Cephalosporins Macrolides Tetracyclines Fluoroquinolones Aminoglycosides Sulfonamides Other Antifungals Antivirals Drug Name Amoxicillin, Dicloxacillin sodium, Amoxicillin and Clavulanate, Ampicillin Cefadroxil, Cephalexin, Cefaclor, Cefprozil, Cefuroxime Axetil, Cefdinir, Cefditoren, Cefixime, Cefpodoxime, Ceftibuten Erythromycin, Azithromycin, Clarithromycin, Fidaxomicin Demeclocycline, Doxycycline, Minocycline, Tetracycline Ciprofloxacin, Levofloxacin, Moxifloxacin, Norfloxacin, Ofloxacin, Gemifloxacin Neomycin, Paromomycin Sulfadiazine, Sulfamethoxazole-Trimethoprim Vancomycin, Telithromycin, Clindamycin, Linezolid Terbinafine, Flucytosine, Griseofulvin, Ketoconazole, Nystatin, Fluconazole, Itraconazole, Posaconazole, Voriconzaole Adefovir dipivoxil, Amantadine HCl, Acyclovir, Famciclovir, Valacyclovir, Boceprevir, Entecavir, Oseltamivir, Ribavirin, Rimantadine HCl, Telaprevir, Valganciclovir
Supplementary Table S4. Distribution of chemotherapy regimens or top five most frequently used agents, by cancer type and febrile neutropenia risk category of chemotherapy regimen Cancer Type, Risk Category, or Agents n % Breast cancer (n = 9110) High risk (n = 923) Dose dense AC + sequential T (doxorubicin, cyclophosphamide, paclitaxel) 494 53.5 TAC (docetaxel, doxorubicin, cyclophosphamide) 355 38.5 Docetaxel + trastuzumab 32 3.5 AT (doxorubicin, paclitaxel) 26 2.8 AT (doxorubicin, docetaxel) ^ ^ Docetaxel every 14 days * * Intermediate risk (n = 908) Paclitaxel every 21 days 351 38.7 CMF classic (cyclophosphamide, methotrexate, fluorouracil) 285 31.4 Paclitaxel, Trastuzumab 174 19.2 Docetaxel every 21 days 74 8.1 FEC (fluorouracil/epirubicin/cyclophosphamide) 24 2.6 Other risk (n = 7279) Top five agents by number of patients received during the course Cyclophosphamide/docetaxel 1595 21.9 Bevacizumab 785 10.8 Capacitabine 521 7.2 Trastuzumab/docetaxel/carboplatin 503 6.9 Trastuzumab 358 4.9 Lung cancer (n = 12,032) High risk (n = 37) Topotecan 37 100.0 Intermediate risk (n = 5130) Carboplatin/paclitaxel 2909 56.7 Etoposide/carboplatin 1202 23.4 Cisplatin/etoposide 674 13.1 Cisplatin/vinorelbine 148 2.9 Docetaxel 87 1.7 Cisplatin/docetaxel 63 1.2 Cisplatin/paclitaxel 24 0.5 Cisplatin/irinotecan 23 0.4 Other risk (n = 6865) Top five agents by number of patients received during the course Docetaxel/carboplatin 550 8.0 Pemetrexed 544 7.9 Carboplatin/pemetrexed 543 7.9 Gemcitabine/carboplatin 455 6.6 Paclitaxel/carboplatin/bevacizumab 419 6.1
Non-Hodgkin lymphoma (n = 6306) High risk (n = 1035) CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) + rituximab 993 95.9 HyperCVAD (cyclophosphamide, vincristine, doxorubicin, dexamethasone) + rituximab 31 3.0 RICE (rituximab, ifosfamide, carboplatin, etoposide) * * MINE (mesna, ifosfamide, novantrone, etoposide) * * CHOP-14 (cyclophosphamide, doxorubicin, vincristine, prednisone) * * ESHAP (etoposide, methylprednisolone, cisplatin, cytarabine) * * Intermediate risk (n = 24) FM (fludarabine, mitoxantrone) 14 58.3 GDP (gemcitabine, dexamethasone, cisplatin) * * EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin) * * GDP (gemcitabine, dexamethasone, cisplatin)+rituximab * * Other risk (n = 5247) Top five agents by number of patients received during the course n % Rituximab 2731 52.0 Cyclophosphamide/rituximab/vincristine 607 11.6 Rituximab/bendamustine 245 4.7 Bevacizumab 120 2.3 Rituximab/fludarabine 108 2.1 * Values for cells with ten or fewer patients are suppressed. ^ Value is suppressed to avoid deriving another cell with ten or fewer patients.