Colorectal cancer is the third most common cancer type nowadays in Europe. Lately however, no treatment has been approved for 1st or 2nd line treatment in metastatic colorectal cancer, only a new treatment option in 3rd line for pretreated patients is available. Therefore it will be interesting to see whether also the existing treatment patterns and testing results have not changed over time.
This study is based on IMS Oncology Analyzer®, a quarterly survey among a physician panel covering retrospective patient data about the disease and the treatment (tx) history across all types of cancer. Metastatic colorectal cancer patients treated in the EU5 countries (France, Germany, Spain, Italy and UK) within 2014, 2015 and 2016 were analyzed.
Comparing the tx guidelines to the tx patterns derived from IMS Oncology Analyzer®, it shows that physicians are following the guidelines for K-RAS wildtype and K-RAS mutant colorectal cancer patients. An analysis of the K-RAS testing shows, that the share of wildtype patients remains almost stable from 2014 to 2016. Unlike in Germany, here the shares of wildtype patients are shrinking from 57.2% to 51.3%. A similar trend accounts for UK. In Spain, France and Italy however, the number of patients, who are wildtype is increasing. Accordingly to the decreasing rate of wildtype patients, the share of Anti-EGFR-therapies is going down in Germany from 38.8% to 25.3%. Also in Italy and Spain the trend of the K-RAS testing is mirrored in the usage of Anti-EGFR-therapies. However, in UK, the use of these therapies increases drastically from 23.9% to 77.8%, despite the decreasing number of K-RAS wildtype patients. In France Anti-EGFR-therapies only lose 1.7% in terms of market shares, even though the K-RAS wildtype population is increasing.
While the general tx guidelines are still followed, some tx patterns have changed due to a difference in K-RAS test results. Further research needs to investigate why there are changes in K-RAS test results. Also studies have shown that tumor localization (right, left, transversum) has an impact on the efficacy. Future studies therefore need to evaluate whether the tumor localization is impacting the tx pattern as well.
Clinical trial identification
Legal entity responsible for the study
All authors have declared no conflicts of interest.