168P - Real-world clinicopathological characteristics and treatment patterns of esophageal cancer patients in China

Background

China accounts for half of new esophageal cancer (EC) cases in the world. Limited new therapies were developed during the past decades until the advent of immuno-oncology (IO) in 2020. Yet real-world data is scarce for Chinese EC patients prior to IO approval. This nationwide multicenter retrospective study aimed to describe clinical features and treatment patterns of EC in China to capture baseline treatment landscape as the benchmark before IO approval.

Methods

Patient-level data of patients who initiated first therapy for newly diagnosed EC in 2018 were extracted from a large nationwide database. Information within 6 months after initial anti-tumor treatment were obtained and descriptively summarized.

Results

A total of 3493 EC patients from 14 hospitals in China were included in this study, with mean age of 64.1 years at initial diagnosis. The majority of patients were male (75.7%), squamous cell carcinoma (92.8%), with primary lesion at middle (56.4%) esophagus and living in urban area (53.4%). The proportion of stage I, II and III and IV was 14.9%, 31.6%, 39.2%,14.2%, respectively. Out of the 2138 resectable patients, 1986 underwent upfront radical surgery, while 7.1% patients received neoadjuvant therapy, among which chemotherapy was mainstay preoperative therapy (85.5%). Twenty-three percent of resectable patients had adjuvant therapy, with chemotherapy as the mainstream (75.2%) postoperative regimen. For unresectable early and locally advanced patients, the percentage of radical therapy and palliative therapy was 49.9% and 50.1%, respectively, and definitive chemoradiotherapy was the most common treatment (32.0%). For advanced stage patients, chemotherapy accounted for 84.3% of upfront therapy and taxane-based chemotherapy regimen predominated (66.2%).

Conclusions

In this large observational study, most early-stage and locally advanced patients underwent upfront surgery without preoperative treatment, while for advanced patients, chemotherapy was the primary choice. This is the first real-world study of EC to date with largest sample size reflecting Chinese treatment landscape before IO approval, which will help address unmet needs in clinical practice.

Clinical trial identification

EU PAS Register Number: EUPAS48396, release on 29/07/2022.

Editorial acknowledgement

Legal entity responsible for the study

Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc. MSD China holding.

Funding

Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc.

Disclosure

D.F. Shi, Q. Jing, S. Shi, F. Dong: Financial Interests, Personal, Full or part-time Employment: MSD China. All other authors have declared no conflicts of interest.