Real-world outcomes among patients with advanced or metastatic biliary tract cancers initiating second-line treatment.

Autor: Cosgrove DP; Compass Oncology, The US Oncology Network, Vancouver, Washington, USA., Reese ES; EMD Serono, Billerica, Massachusetts, USA., Fulcher NM; Ontada, The Woodlands, Texas, USA., Bobiak SS; EMD Serono, Billerica, Massachusetts, USA., Lamy FX; Healthcare Business of Merck KGaA, Darmstadt, Germany., Allignol A; Healthcare Business of Merck KGaA, Darmstadt, Germany., Boyd M; Ontada, The Woodlands, Texas, USA., Mahmoudpour SH; Healthcare Business of Merck KGaA, Darmstadt, Germany.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2023 Feb; Vol. 12 (4), pp. 4195-4205. Date of Electronic Publication: 2022 Oct 20.
DOI: 10.1002/cam4.5282
Abstrakt: Background: Limited data are available regarding second-line (2 L) treatment for advanced or metastatic biliary tract cancers (BTC) in the US real-world setting. This study explores the rapidly evolving and growing treatment landscape in the 2 L setting for advanced or metastatic BTC with a large cohort of patients treated in a community oncology setting.
Methods: Adult patients with BTC initiating 2 L treatment after a platinum-containing first-line between 1/1/10- and 6/30/19 were identified from the US Oncology Network electronic healthcare record database and followed through 12/31/19. Baseline patient and treatment characteristics were analyzed descriptively, including overall response rate (ORR) in the real-world clinical setting. Kaplan-Meier methods were used to measure duration of response, progression-free survival (PFS), and overall survival (OS).
Results: The overall population (N = 160) included 74 patients (46.3%) with intrahepatic cholangiocarcinoma, 41 (25.6%) with extrahepatic cholangiocarcinoma, and 45 (28.1%) with gallbladder cancer. Thirty unique 2 L regimens were recorded for the study population, with folinic acid, fluorouracil and oxaliplatin (FOLFOX, 34.4%) and capecitabine monotherapy (20.0%) being the most common. ORR was 7.5% (95% CI, 3.9%-12.7%). From 2 L initiation, median PFS was 2.8 months (95% CI, 2.4-3.3 months), and median OS was 5.2 months (95% CI, 4.2-6.7 months).
Conclusion: Results from this study provide real-world evidence that although patients treated in the community oncology setting receive a wide variety of 2 L treatments, the regimens are consistent with those recommended by guidelines. Although responses are observed with 2 L treatment, duration is brief and associated with poor OS in patients with advanced or metastatic disease.
(© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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