Abstract 5204
Background
Colorectal cancer (CRC) is biologically heterogeneous with 4 distinct consensus molecular subtypes (CMSs) leading to different prognosis and different response to anti-VEGF and anti-EGFR agents, and different CMSs profiles in Right, Transverse (Trv), and Left location of primary CRC. We aim at describing the patterns of care by the location of primary CRC to provide the baseline reference for future research.
Methods
Anonymized CRC patients-level data collected through a large web-based survey between 9217 patients in EU5 (France, Germany, Italy, Spain & UK) and APAC (China, Japan & S. Korea) collected between January – December 2017.
Results
Data from overall 9217 (5041 advanced) pts from EU5 and APAC was analyzed. Left, Right, and Trv CRC location proportion was similar across regions (Left: 52% all pts, 53% EU5, 50% APAC; Right: 39% all pts, 39% EU5, 40% APAC; Trv: 9% all pts, 8% EU5, 10% APAC). Slightly more pts with liver metastases was reported for Left location of CRC (42% all pts, 44% EU5, 38% APAC) than Right (40% all pts, 43% EU5, 31% APAC) or Trv (37% all pts, 40% EU5, 31% APAC). The incidence of biomolecular alterations was: KRAS mutant: Left 38%, Right 45%, Trv 43%; NRAS mutant: Left 27%, Right 32%, Trv 32%; BRAF mutant: Left 7%, Right 12%, Trv 12%; High MSI: Left 16%, Right 22%, Trv 25%; PD-1/PDL-1/2 positive: Left 17%, Right 13%, Trv 25% ( PD-1/PDL-1/2 testing on 225/9217 pts, 2,4%). More Bevacizumab based treatments are used for primary Right location, and more anti-EGFR based therapy for primary Left location. The use of Immunotherapy was minimal, with these pts tested for either MSI or PD-1/L1 expressed.Table: 587P
| Treatments | LEFT | RIGHT | TRANSVERSE | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Total | EU5 | APAC | Total | EU5 | APAC | Total | EU5 | APAC | |
| % | % | % | % | % | % | % | % | % | |
| Bevacizumab based | 17 | 17 | 18 | 22 | 22 | 20 | 16 | 16 | 19 |
| Anti EGFR based | 14 | 16 | 7 | 8 | 9 | 6 | 11 | 12 | 5 |
| Immunotherapy based | 0,04 | 0,03 | 0,10 | 0,03 | 0,04 | -- | 0,12 | 0,17 | -- |
Conclusions
This real-world data currently highlights slight but not marked differences in the management of disease in the Left, Right, and Transverse primary location of CRC. Over time we anticipate that differences will arise with primary location of CRC being increasingly considered for the clinical management of CRC.
Clinical trial identification
Legal entity responsible for the study
IQVIA United Kingdom.
Funding
IQVIA United Kingdom.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
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