P-090 - Real-world treatment patterns of previously treated advanced gastric and gastroesophageal junction adenocarcinoma (GC) in France

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Anticancer agents
Oesophageal Cancer
Gastric Cancer
Therapy
Biological Therapy
Presenter A. Liepa
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors A. Liepa1, J. Brown2, B. Bapat3, G. Sleilaty4, J. Kaye5
  • 1Eli Lilly and Company, Indianapolis/US
  • 2Eli Lilly and Company, Windlesham/UK
  • 3Evidera, Lexington/US
  • 4Lilly France SAS, Neuilly-sur-Seine/FR
  • 5RTI Health Solutions, Waltham/US

Abstract

Introduction

With no licensed therapies for previously treated advanced GC until recently, little is known on how patients who have failed first-line chemotherapy are managed. We present real-world data on characteristics, treatments, and resource utilization for such patients in France.

Methods

Physicians who treat patients with advanced GC were asked to complete a web-based chart review detailing clinical and resource utilization data for 3 to 4 de-identified patients each. Regional quotas were used to provide a geographic distribution of physicians. Eligible patients were ≥18 years old, diagnosed between January 2007 and March 2012 with advanced GC, received first-line fluoropyrimidine + platinum, had ≥3 months of follow-up after first-line discontinuation, and had not participated in a clinical trial. Data were summarized descriptively, with cohorts based on second-line chemotherapy versus no further chemotherapy.

Results

From June to July 2013, 56 physicians provided data for 201 patients. Patients' mean age was 61 (±9.1) years and 76% were male. Patients were treated and followed in general hospitals (35%), university or regional hospitals (32%), specialized cancer hospitals (19%), or private clinics (14%). When initiating first-line chemotherapy, ECOG performance status (PS) was 19% 0, 61% 1, and 19% 2. The most common first-line regimens were 5-FU + oxaliplatin (24%), 5-FU + cisplatin (16%), and 5-FU + cisplatin + docetaxel (10%). The most common reasons for first-line chemotherapy discontinuation were completion of planned regimen (43%) and disease progression (39%). ECOG PS at first-line chemotherapy discontinuation was 7% 0, 46% 1, 36% 2, and 10% 3. A total of 55% of patients received second-line chemotherapy, and 68% of these patients had PS 0/1 at the start of second-line chemotherapy. The most common second-line regimens were 5-FU + irinotecan (37%), docetaxel (10%), 5-FU + oxaliplatin + leuocovorin (7%), 5-FU + irinotecan + leucovorin (6%), and capecitabine (6%). Among patients who received second-line chemotherapy, 18% received third-line chemotherapy. After first-line chemotherapy discontinuation, rates of supportive care for those with second-line versus those without further chemotherapy were: pain interventions, 50% versus 61%; anti-emetics, 39% versus 37%; nutritional support, 41% versus 42%; and transfusions, 19% versus 21%. After first-line chemotherapy discontinuation, rates of resource utilization for those with second-line versus those without further chemotherapy were: office visits (other than for chemotherapy administration), 63% versus 62%; emergency department visits, 37% versus 27%; inpatient hospitalization, 43% versus 40%; and hospice, 17% versus 18%. The most common contributing reasons for hospitalization were disease progression and palliative care; patients were most commonly treated within oncology wards.

Conclusion

In this study sample of advanced GC patients from France, slightly more than half of patients received second-line chemotherapy, but there was considerable variation in regimens. Rates of supportive care were similar between those with second-line chemotherapy and those without, except for of a lower rate of pain interventions in the chemotherapy cohort. Rates of resource utilization were similar, except for of a higher rate of emergency department visits in the chemotherapy cohort.