Real-world treatment attrition rates in advanced esophagogastric cancer

作     者：Erica S Tsang Howard J Lim Daniel J Renouf Janine M Davies Jonathan M Loree Sharlene Gill 

作者机构：Department of MedicineBC CancerVancouver V5Z 4E6Canada Division of Medical OncologyUniversity of British ColumbiaVancouver V5Z 4E6Canada 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2020年第26卷第39期

页      面：6027-6036页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：This study was reviewed and approved by Systemic Therapy-Vancouver(BC Cancer) REB number H19-01865 

主　　题：Esophagogastric cancer Gastric cancer Treatment attrition Systemic therapy Treatment outcomes Real-world evidence 

摘      要：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 *** To characterize the use and attrition rates between lines of therapy for patients with advanced *** 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),***,treatment,and outcomes data were *** 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 *** 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,P0.05).On multivariable Cox regression,improved survival was associated with better baseline ECOG and increased lines of therapy(P0.05).CONCLUSION The steep attrition rates between therapies highlight the unmet need for more efficacious early-line treatment options for patients with advanced EGC.