Dataset Information

Real-world treatment attrition rates in advanced esophagogastric cancer.

ABSTRACT:

Background

Over the last decade, multiple agents have demonstrated efficacy for advanced esophagogastric cancer (EGC). Despite the availability of later lines of therapy, there remains limited real-world data about the treatment attrition rates between lines of therapy.

Aim

To characterize the use and attrition rates between lines of therapy for patients with advanced EGC.

Methods

We identified patients who received at least one cycle of chemotherapy for advanced EGC between July 1, 2017 and July 31, 2018 across six regional centers in British Columbia (BC), Canada. Clinicopathologic, treatment, and outcomes data were extracted.

Results

Of 245 patients who received at least one line of therapy, median age was 66 years (IQR 58.2-72.3) and 186 (76%) were male, Eastern Cooperative Oncology Group (ECOG) performance status 0/1 (80%), gastric vs GEJ (36% vs 64%). Histologies included adenocarcinoma (78%), squamous cell carcinoma (8%), and signet ring (14%), with 31% HER2 positive. 72% presented with de novo disease, and 25% had received previous chemoradiation. There was a high level of treatment attrition, with patients receiving only one line of therapy n = 122, 50%), two lines n = 83, 34%), three lines n = 34, 14%), and four lines n = 6, 2%). Kaplan-Meier analysis demonstrated improved survival with increasing lines of therapy (median overall survival 7.7 vs 16.6 vs 22.8 vs 40.4 mo, P < 0.05). On multivariable Cox regression, improved survival was associated with better baseline ECOG and increased lines of therapy (P < 0.05).

Conclusion

The steep attrition rates between therapies highlight the unmet need for more efficacious early-line treatment options for patients with advanced EGC.

SUBMITTER: Tsang ES

PROVIDER: S-EPMC7584053 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Real-world treatment attrition rates in advanced esophagogastric cancer.

Tsang Erica S ES Lim Howard J HJ Renouf Daniel J DJ Davies Janine M JM Loree Jonathan M JM Gill Sharlene S

World journal of gastroenterology 20201001 39

<h4>Background</h4>Over the last decade, multiple agents have demonstrated efficacy for advanced esophagogastric cancer (EGC). Despite the availability of later lines of therapy, there remains limited real-world data about the treatment attrition rates between lines of therapy.<h4>Aim</h4>To characterize the use and attrition rates between lines of therapy for patients with advanced EGC.<h4>Methods</h4>We identified patients who received at least one cycle of chemotherapy for advanced EGC betwee ...[more]

PMID: 33132652

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Project description:BACKGROUND:The objective of this study was to describe the real-world treatment and overall survival (OS) of German patients with a diagnosis of advanced non-small cell lung cancer (aNSCLC), and to explore factors associated with the real-world mortality risk. METHODS:This was a retrospective German claims data analysis of incident aNSCLC patients. Data were available from 01/01/2011 until 31/12/2016. Identification of eligible patients took place between 01/01/2012-31/12/2015, to allow for at least 1-year pre-index and follow-up periods. Inpatient and outpatient mutation test procedures after aNSCLC diagnosis were observed. Further, prescribed treatments and OS since first (incident) aNSCLC diagnosis and start of respective treatment lines were described both for all patients and presumed EGFR/ALK/ROS-1-positive patients. Factors associated with OS were analyzed in multivariable Cox regression analysis. RESULTS:Overall, 1741 aNSCLC patients were observed (mean age: 66·97?years, female: 29·87%). The mutation test rate within this population was 26·31% (n?=?458), 26·6% of these patients (n?=?122) received a targeted treatment and were assumed to have a positive EGFR/ALK/ROS-1 test result. Most often prescribed treatments were pemetrexed monotherapy as 1?L (21·23% for all and 11·11% for mutation-positive patients) and erlotinib monotherapy as 2?L (25·83%/38·54%). Median OS since incident diagnosis was 351?days in all and 571?days in mutation-positive patients. In a multivariable Cox regression analysis, higher age, a stage IV disease, a higher number of chronic drugs in the pre-index period and no systemic therapy increased the risk of early death since first aNSCLC diagnosis. On the other hand, female gender and treatment with therapies other than chemotherapy were associated with a lower risk of early death. CONCLUSIONS:Despite the introduction of new treatments, the real-world survival prognosis for aNSCLC patients remains poor if measured based on an unselected real-world population of patients. Still, the majority of German aNSCLC patients do not receive a mutation test.

Dataset Information

Real-world treatment attrition rates in advanced esophagogastric cancer.

Background

Aim

Methods

Results

Conclusion

Publications

Real-world treatment attrition rates in advanced esophagogastric cancer.

Similar Datasets

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