ESMO Asia Virtual Congress 2020

Abstract 151P

Background

Gastric cancer (GC) is the fourth leading cause of cancer-related deaths in Taiwan. Even with significant strides that have been made in GC early detection and management in Taiwan in recent years, patients with GC (including gastro-esophageal junction cancer, GEJC) that present with unresectable advanced metastatic disease (UAM) remain at risk for poor survival outcomes.

Methods

This was a retrospective ‘real world’ observational study using the linked Taiwan National Health Insurance Research Database, which contains health claims data on almost the entire Taiwan population, and the Taiwan National Cancer Registry. Patients having at least one hospital record with a primary ICD-9 or ICD-10 code of GC/GEJC were selected from Jan 1st, 2013 through Dec 31st, 2018. The first date of GC/GEJC diagnosis was defined as the index date. Patients were followed for a minimum ± 30 days from the index date and were stratified by staging, clinical presentation [i.e. resectable vs. unresectable advanced metastatic (UAM)]. Key characteristics such as demographics, clinical parameters, medication utilization, health care resource utilization, costs incurred, and survival were tracked for the overall population and both cohorts.

Results

A total of 3736 UAM GC patients were identified with a mean age of 68.0 (sd=15.2) years, with most patients being male (n=2248, 60.2%). The majority of UAM GC patients were Stage 4 (n=2270, 60.8%) and most patients were identified as having adenocarcinoma (n=2847, 76.2%). Nearly half the patients received 1st line (1L) therapy (n=1846, 49.4%) with the most common 1L therapies being Capecitabine + Oxaliplatin (n=604, 32.7% of 1L), S-1 (n=280, 15.2% of 1L) and Capecitabine monotherapy (n=209, 11.3% of 1L). Only 38.2% (n=1428) of patients survived 1 year with the annualized post-index GC-related costs being New Taiwan (NT) $ 396,590 (sd = NT$ 412,523).

Conclusions

The most common 1L chemotherapeutic treatments for UAM GC patients were Capecitabine + Oxaliplatin, S-1 and Capecitabine. In Taiwan, UAM GC patients appear to have poor survival and incur high GC-related costs, which suggests the need for new treatment options.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Bristol-Myers Squibb Pharmaceuticals Corp.

Funding

Bristol-Myers Squibb Pharmaceuticals Corp.

Disclosure

C.J. Chang, Y. Tsai, H.S. Friedman, P. Navaratnam: Research grant/Funding (self): Bristol-Myers Squibb. J. Gricar, H. Xiao: Shareholder/Stockholder/Stock options, Full/Part-time employment: Bristol-Myers Squibb.