Patient demographics and management landscape of metastatic colorectal cancer in the third-line setting: Real-world data in an australian population.
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Australia
/ epidemiology
Colonic Neoplasms
/ drug therapy
Colorectal Neoplasms
/ drug therapy
Demography
ErbB Receptors
Humans
Neoplasm Recurrence, Local
/ drug therapy
Proto-Oncogene Proteins p21(ras)
Rectal Neoplasms
/ drug therapy
Retrospective Studies
Trifluridine
/ therapeutic use
metastatic colorectal cancer
real-world practice
rechallenge
registry data
third-line treatment
Journal
Asia-Pacific journal of clinical oncology
ISSN: 1743-7563
Titre abrégé: Asia Pac J Clin Oncol
Pays: Australia
ID NLM: 101241430
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
26
05
2020
accepted:
02
12
2020
pubmed:
20
4
2021
medline:
9
4
2022
entrez:
19
4
2021
Statut:
ppublish
Résumé
Colorectal cancer is the third most common cancer and second leading cause of cancer mortality in Australia, thus carrying a significant disease burden. This analysis aims to explore real-world treatment landscape of metastatic colorectal cancer in the third-line setting. We retrospectively analysed treatment of recurrent and advanced colorectal cancer (TRACC) registry database from 2009 onwards. Patients treated with palliative intent who progressed after two lines of therapies were included. One treatment line was defined as any combination of systemic therapy given until progression. Out of 1820 patients treated palliatively, 32% (590 patients) met study criteria. Of these, 43% (254 patients) proceeded to third-line therapy, equating to 14% of all metastatic patients. In KRAS mutant or unknown tumours (97 patients), fluoropyrimidine (FP)-oxaliplatin combination was the most common choice (51%), followed by FP-irinotecan (15%), trifluridine/tipiracil (11%), mono-chemotherapy (10%), regorafenib (5%) and others (7%). Majority of FP-doublet (83%) was given as rechallenge. In 157 patients with KRAS wildtype disease, monotherapy with EGFR inhibitor was most commonly used (41%), followed by EGFR inhibitor with chemotherapy (20%), FP-doublet (18%), mono-chemotherapy (6%), trifluridine/tipiracil (6%), regorafenib (1%) and others (8%). Median overall survival was 7.1 months (range 0.4-41.2), and median time on third-line treatment was 3 months (range 0.1-40). In real-world Australian population, treatment choices differed based on KRAS status and will likely change with the availability of newer drugs on the pharmaceutical benefits scheme. Survival outcomes are comparable to newer agents in clinical trials for select patients.
Sections du résumé
BACKGROUND
BACKGROUND
Colorectal cancer is the third most common cancer and second leading cause of cancer mortality in Australia, thus carrying a significant disease burden.
AIMS
OBJECTIVE
This analysis aims to explore real-world treatment landscape of metastatic colorectal cancer in the third-line setting.
METHODS
METHODS
We retrospectively analysed treatment of recurrent and advanced colorectal cancer (TRACC) registry database from 2009 onwards. Patients treated with palliative intent who progressed after two lines of therapies were included. One treatment line was defined as any combination of systemic therapy given until progression.
RESULTS
RESULTS
Out of 1820 patients treated palliatively, 32% (590 patients) met study criteria. Of these, 43% (254 patients) proceeded to third-line therapy, equating to 14% of all metastatic patients. In KRAS mutant or unknown tumours (97 patients), fluoropyrimidine (FP)-oxaliplatin combination was the most common choice (51%), followed by FP-irinotecan (15%), trifluridine/tipiracil (11%), mono-chemotherapy (10%), regorafenib (5%) and others (7%). Majority of FP-doublet (83%) was given as rechallenge. In 157 patients with KRAS wildtype disease, monotherapy with EGFR inhibitor was most commonly used (41%), followed by EGFR inhibitor with chemotherapy (20%), FP-doublet (18%), mono-chemotherapy (6%), trifluridine/tipiracil (6%), regorafenib (1%) and others (8%). Median overall survival was 7.1 months (range 0.4-41.2), and median time on third-line treatment was 3 months (range 0.1-40).
CONCLUSIONS
CONCLUSIONS
In real-world Australian population, treatment choices differed based on KRAS status and will likely change with the availability of newer drugs on the pharmaceutical benefits scheme. Survival outcomes are comparable to newer agents in clinical trials for select patients.
Substances chimiques
ErbB Receptors
EC 2.7.10.1
Proto-Oncogene Proteins p21(ras)
EC 3.6.5.2
Trifluridine
RMW9V5RW38
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e56-e63Informations de copyright
© 2021 John Wiley & Sons Australia, Ltd.
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