Time on treatment and treatment patterns in patients with metastatic colorectal carcinoma: a retrospective chart review


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Anna Ryan1,Daniel Sugrue2,Michael Hurst2,Pratik Thakkar3,Sidonie Hartridge-Lambert3,Hamzeh Kayhanian1,Jason Gordon2,Manuel Rodriguez-Justo1,Kai-Keen Shiu1,Dionysios Ntais3
1University College London Hospital,2Health Economics and Outcomes Research Ltd.,3Bristol-Myers Squibb

Abstract

Background

Colorectal cancer (CRC) is the second most diagnosed cancer in Europe and a leading cause of death. This study aimed to characterise treatment patterns and time on treatment of metastatic CRC (mCRC) patients in the UK.

Method

This was an observational, single-centre, retrospective cohort study of patients with mCRC identified through a longitudinal medical chart review, treated at the University College London Hospital (UCLH) between 2011-2016. The index date was defined as the date of first confirmed diagnosis of mCRC.

Results

In total, 107 patients (mean age 58.8 years, male [52.3%] with ECOG PS 0/1 [70.4%]) met eligibility criteria. All patients received first line therapy for a median duration of 7.8 months, including: FOLFOX only (n=36), FOLFIRI only (n=13), FOLFOX+bevacizumab (n=15), FOLFIRI+bevacizumab (n=11), FOLFOX+cetuximab (n=1), FOLFIRI+cetuximab (n=7), XELOX only (n=5), other (n=17) or best supportive care (n=2). Second- and third-line therapy were received by 80 (75%) and 45 (42%) patients, respectively, for a median duration of 5.3 months and 4.6 months. Fourth and fifth lines of therapy were received by 20 (19%) and 11 (10%) patients, respectively. The most common adverse events experienced across all treatments were Grade 1/2, while Grade 3/4 adverse events experienced by more than 5% of the cohort included fatigue (24.3%), diarrhoea (8.4%), neuropathy (Grade 3, 8.4%; Grade 2, 15.9%), neutropenia (7.5%) and vomiting (8.4%).

Conclusion

Patients received fluoropyrimidine-, oxaliplatin- or irinotecan-based chemotherapy regimens +/- targeted therapies, which appeared broadly reflective of UK clinical guidelines over the study period.

This real-world data illustrates the toxicity associated with cytotoxic regimens and demonstrates the need for chemotherapy-sparing strategies.

Acknowledgements: Prof Daniel Hochhauser, Prof John Bridgewater, Conor Daly and Ayman Nassar