Ruihua Xu1, Wei Wang2, Bo Zhu3, Xiaoyan Lin4, Dong Ma5, Lingjun Zhu6, Qingchuan Zhao7, Yongzhan Nie7, Xiaohong Cai8, Qi Li9, Weijia Fang10, Hongyan Li11, Ning Wang11, Yun Chen11, Cike Peng12, Honghao Fang13, Lin Shen14. 1. Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China. 2. The First People's Hospital of Foshan, No. 81 North Lingnan Road, Chancheng District, Foshan, 528000, China. 3. Xinqiao Hospital, Third Military Medical University, No. 83 Xinqiaozheng Street, Shapingbei District, Chongqing, 400037, China. 4. Fujian Medical University Union Hospital, No. 29 Xinquan Road, Gulou District, Fuzhou, 350001, China. 5. Guangdong General Hospital, No.106 Zhongshan Road, Yuexiu District, Guangzhou, 510245, China. 6. Jiangsu Province Hospital, No.300 Guangzhou Road, Gulou District, Nanjing, 210029, China. 7. Xijing Hospital, Fourth Military Medical University, No.15 West Road, Xincheng District, 710032, Xi'an, Changle, China. 8. Sichuan Cancer Hospital and Institute, No.55 Sectional 4, South Renmin Road, Wuhou District, Chengdu, 610015, China. 9. Shanghai General Hospital, No.100 Haining Road, Hongkou District, Shanghai, 200080, China. 10. The First Hospital of Zhejiang Province, No.79 Qingchun Road, Shangcheng District, Hangzhou, 310002, China. 11. Eli Lilly and Company China Affiliate, No. 288 Shi Men Yi Lu, Jing'an District, Shanghai, 200041, China. 12. Eli Lilly and Company China Affiliate, No. 288 Shi Men Yi Lu, Jing'an District, Shanghai, 200041, China. Peng_ci_ke@lilly.com. 13. IQVIA, No. 968 West Beijing Road, Jing'an District, Shanghai, 200063, China. 14. Beijing Cancer Hospital, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China.
Abstract
BACKGROUND: Colorectal cancer (CRC) is the third most prevalent cancer in China but few large-scale studies were conducted to understand CRC patients. The current study is aimed to gain a real-world perspectives of CRC patients in China. METHODS: Using electronic medical records of sampled patients between 2011 and 2016 from 12 hospitals in China, a retrospective cohort study was conducted to describe demographics and disease prognosis of CRC patients, and examine treatment sequences among metastatic CRC (mCRC) patients. Descriptive, comparative and survival analyses were conducted. RESULTS: Among mCRC patients (3878/8136, 48%), the fluorouracil, leucovorin, and oxaliplatin (FOLFOX) and other oxaliplatin-based regimens were the most widely-used first-line treatment (42%). Fluorouracil, leucovorin, irinotecan (FOLFIRI) and other irinotecan-based regimens dominated the second-line (40%). There was no a dominated regimen for the third-line. The proportion of patients receiving chemotherapy with targeted biologics increased from less than 20% for the first- and second- lines to 34% for the third-line (p < 0.001). The most common sequence from first- to second-line was from FOLFOX and other oxaliplatin-based regimens to FOLFIRI and other irinotecan-based regimens (286/1200, 24%). CONCLUSIONS: Our findings reflected a lack of consensus on the choice of third-line therapy and limited available options in China. It is evident o continue promoting early CRC diagnosis and to increase the accessibility of treatment options for mCRC patients. As the only nationwide large-scale study among CRC and mCRC patients before more biologics became available in China, our results can also be used as the baseline to assess treatment pattern changes before and after more third-line treatment were approved and covered into the National Health Insurance Plan in China between 2017 and 2018.
BACKGROUND:Colorectal cancer (CRC) is the third most prevalent cancer in China but few large-scale studies were conducted to understand CRCpatients. The current study is aimed to gain a real-world perspectives of CRCpatients in China. METHODS: Using electronic medical records of sampled patients between 2011 and 2016 from 12 hospitals in China, a retrospective cohort study was conducted to describe demographics and disease prognosis of CRCpatients, and examine treatment sequences among metastatic CRC (mCRC) patients. Descriptive, comparative and survival analyses were conducted. RESULTS: Among mCRC patients (3878/8136, 48%), the fluorouracil, leucovorin, and oxaliplatin (FOLFOX) and other oxaliplatin-based regimens were the most widely-used first-line treatment (42%). Fluorouracil, leucovorin, irinotecan (FOLFIRI) and other irinotecan-based regimens dominated the second-line (40%). There was no a dominated regimen for the third-line. The proportion of patients receiving chemotherapy with targeted biologics increased from less than 20% for the first- and second- lines to 34% for the third-line (p < 0.001). The most common sequence from first- to second-line was from FOLFOX and other oxaliplatin-based regimens to FOLFIRI and other irinotecan-based regimens (286/1200, 24%). CONCLUSIONS: Our findings reflected a lack of consensus on the choice of third-line therapy and limited available options in China. It is evident o continue promoting early CRC diagnosis and to increase the accessibility of treatment options for mCRC patients. As the only nationwide large-scale study among CRC and mCRC patients before more biologics became available in China, our results can also be used as the baseline to assess treatment pattern changes before and after more third-line treatment were approved and covered into the National Health Insurance Plan in China between 2017 and 2018.
Entities:
Keywords:
China; Colorectal cancer; Medical records; Real-world evidence; Treatment patterns