Abstract 503P
Background
The SCOPE survey, undertaken in 12 countries, aimed to assess “real-world” current clinical practice in patients (pts) with pretreated metastatic colorectal cancer. We report on treatment (Tx) goals and practice patterns in the third- (3) and fourth- (4) line (L) settings.
Methods
An expert panel of gastrointestinal oncologists developed the survey. Questions concerned general practice patterns and Tx options in 3 different case scenarios in the 3L and 4L settings. Data were collected at in-person meetings. Only healthcare providers (HCPs) who gave input on pt Tx scenarios were included in this analysis.
Results
As of 17 January 2020, 629 HCPs had participated. Most were medical oncologists (69%), practiced in university hospitals (47%), saw 10–19 pts/month (31%), and were 35–55 years old (58%). In 3L, quality of life (QOL) was the singular most common primary goal (34%). Interestingly, 43% of HCPs cited an efficacy-focused goal as their main aim: 18%, prolonging overall survival; 13%, improving progression-free survival; 10%, stabilizing disease; and 2%, shrinking tumor size. These efficacy objectives were reflected in the preferred 3L Tx choices. For fit and active pts, 89% considered trifluridine-tipiracil an appropriate 3L Tx on the basis of the survival benefit (54%) and disease control rate (44%) observed in trial data; in 4L setting, regorafenib (31%) or clinical trial enrollment (29%) were preferred. For pts with comorbidities and limited caregiver support, trifluridine-tipiracil was also the preferred 3L Tx (70% compared with 7% for regorafenib). For KRAS-mutated pts with comorbidities and adverse events who were previously treated with oxaliplatin, 90% considered oxaliplatin rechallenge an unsuitable 3L Tx mostly due to the risk of cumulative toxicity on everyday life (75%). In the 3L/4L settings, trifluridine-tipiracil followed by regorafenib was the most commonly chosen option (50%), while 21% opted for regorafenib followed by trifluridine-tipiracil.
Conclusions
Our data show that efficacy coupled with QOL are important goals in 3L. This is reflected in the preferred 3L and 4L Tx choices.
Clinical trial identification
Editorial acknowledgement
Medical writing support was provided by Joanne Franklin, PhD, CMPP, from Aptitude Health, The Hague, the Netherlands, and funded by Servier.
Legal entity responsible for the study
Servier.
Funding
Servier.
Disclosure
G. Prager: Advisory/Consultancy, Research grant/Funding (institution): Celgene; Research grant/Funding (institution): Array; Advisory/Consultancy, Research grant/Funding (institution): Servier; Advisory/Consultancy, Research grant/Funding (institution): Bayer; Research grant/Funding (institution): BostonBiomedical; Research grant/Funding (institution): Merck; Advisory/Consultancy, Research grant/Funding (institution): BMS; Advisory/Consultancy, Research grant/Funding (institution): Pierre Fabre; Advisory/Consultancy: Merck Serono; Advisory/Consultancy: Roche; Advisory/Consultancy: Amgen; Research grant/Funding (institution): Sanofi; Advisory/Consultancy: Lilly; Advisory/Consultancy: Taho; Advisory/Consultancy: Halozyme; Advisory/Consultancy: Terumo; Advisory/Consultancy: Shire. F. Rivera: Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Servier; Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: MSD; Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: Roche; Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: Merck-Serono; Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: Amgen; Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (self), Research grant/Funding (institution): Sanofi-Aventis; Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Pierre-Fabre; Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (self), Research grant/Funding (institution): Lilly; Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Bayer; Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: BMS; Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Astra-Zeneca; Honoraria (institution): Pfizer. H. Wasan: Advisory/Consultancy: Incyte; Advisory/Consultancy: Pierre Fabre; Advisory/Consultancy: Servier; Advisory/Consultancy, Non-remunerated activity/ies, Nice expert (uncompensated): Bayer; Advisory/Consultancy: Roche/Genentech; Advisory/Consultancy: FM AG; Advisory/Consultancy: Sirtex medical; Advisory/Consultancy: Erytech Pharma; Advisory/Consultancy: Celgene; Advisory/Consultancy: Array BioPharma; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Pfizer; Advisory/Consultancy: Zymeworks; Advisory/Consultancy: Shire; Advisory/Consultancy: Oncosil; Advisory/Consultancy: Oaktree capital; Honoraria (self), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: BTG/Biocompatibles; Honoraria (self), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Merck KGaA; Honoraria (self), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Sirtex. All other authors have declared no conflicts of interest.