Abstract 1402P
Background
Perioperative Chemotherapy (PCT) is considered the standard treatment for locally advanced gastroesophageal cancer (GEC) since the 2006 MAGIC trial (Cunningham et al.) reported a 5-year overall survival (OS) of 36% in PCT patients and 23% for surgery (SG) alone. 89% of the enrolled patients were <70 years, 21% were aged 70+. In Europe and the US many population-based cancer registries (CRs) gather data on treatment, which can be used to assess care patterns at population level and evaluate the reproducibility of clinical trial results in the real world.
Methods
Data from CRs contributing to the European Cancer Information System with treatment information and data from the US National Cancer Institute Surveillance, Epidemiology and End Results (SEER) were analysed, selecting patients diagnosed in 1994-2014 (Europe) and 2004-2013 (USA) with Stage II-III GEC as first tumour. The proportion of cases by treatment type, OS and relative survival (RS) were calculated by period for SG alone and SG plus systemic therapy (ST).
Results
106,359 cases from 21 CRs in 13 European countries and 11,553 cases from 18 US CRs were analysed. Patients <70 years were 54% of the total and those 70+ were 46%. In Europe, 55% of cases received SG and 14% SG+ST in 1994-2005. Percentages were 46% SG and 29% SG+ST in 2006-2014. Proportion of SG+ST increased from 21% to 42% for 18-69 years old, from 5% to 15% in 70+ patients in the same periods. In the US, therapy was 20% SG and 50% SG+ST in 2006-2014. In Europe, 5-year RS was 30% for SG and 31% for SG+ST in 1994-2005, 32% for SG and 31% for SG+ST in 2006-2014. In the US, RS was 27% for SG and 41% for SG+ST in 2006-2013. Five-year OS was 26% in Europe and 22% in the US for SG, 28% and 38% respectively for SG+ST in 2006-2014.
Conclusions
A change in GEC treatment modality was observed in Europe. The adoption of SG+ST was more common in the US and in younger patients. Survival rates remained stable in Europe in the period following the 2006 MAGIC results. Survival data by treatment group from the US is matching trial findings, whereas survival is similar between different treatment approaches in Europe. CRs are a powerful tool to monitor shifts in treatment patterns and measure treatment effects in the general population.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.