Clinical management patterns of advanced and metastatic gastro-oesophageal carcinoma after fluoropyrimidine/platinum treatment in France, Germany, Spain and the United Kingdom

Eur J Cancer Care (Engl). 2020 Mar;29(2):e13213. doi: 10.1111/ecc.13213. Epub 2019 Dec 27.

Abstract

Objective: To describe treatment patterns and resource utilisation in France, Germany, Spain and the United Kingdom (UK) in patients with unresectable locally advanced and/or metastatic gastro-oesophageal adenocarcinoma (GEA), who failed first-line fluoropyrimidine/platinum treatment.

Methods: Treating physicians completed a web-based chart review (2013-2015). Eligible patients were ≥ 18 years old; had unresectable locally advanced and/or metastatic gastric adenocarcinoma including the gastro-oesophageal junction; received first-line fluoropyrimidine/platinum-based therapy; and had ≥ 3 months of follow-up after first-line discontinuation. Data were summarised descriptively for each country.

Results: There were n = 201 patients in France, n = 202 in Germany, n = 208 in Spain and n = 200 in the UK whose charts were reviewed. Percentages of patients receiving second-line therapy were 55% (France), 48% (Germany), 54% (Spain) and 29% (UK). At the start of second-line therapy, most patients had an ECOG performance status of 1 (range 0-3). Second-line therapy was primarily monotherapy, but agents used varied within and across countries. Supportive care use and resource utilisation were frequent whether receiving additional therapy or not; >60% patients had clinic visits unrelated to chemotherapy administration, and > 30% has ≥ 1 hospital admission.

Conclusions: For the time of study, established GEA treatment guidelines were generally followed. However, therapies varied widely in the second-line setting.

Keywords: advanced gastric cancer; chart review; gastro-oesophageal adenocarcinoma; metastatic gastric cancer; resource utilisation; treatment patterns.

Publication types

  • Observational Study

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / pathology
  • Adenocarcinoma / secondary
  • Adult
  • Aged
  • Ambulatory Care / statistics & numerical data
  • Analgesics, Opioid / therapeutic use
  • Antiemetics / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Capecitabine / administration & dosage
  • Cisplatin / administration & dosage
  • Disease Progression
  • Docetaxel / administration & dosage
  • Emergency Service, Hospital / statistics & numerical data
  • Epirubicin / administration & dosage
  • Esophagogastric Junction*
  • Female
  • Fluorouracil / administration & dosage
  • France
  • Germany
  • Guideline Adherence / statistics & numerical data*
  • Hospice Care / statistics & numerical data
  • Hospitalization / statistics & numerical data
  • Humans
  • Irinotecan / administration & dosage
  • Male
  • Middle Aged
  • Nutritional Support
  • Oxaliplatin / administration & dosage
  • Palliative Care / statistics & numerical data*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Receptor, ErbB-2 / genetics
  • Retrospective Studies
  • Spain
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / pathology
  • Treatment Failure
  • United Kingdom

Substances

  • Analgesics, Opioid
  • Antiemetics
  • Oxaliplatin
  • Docetaxel
  • Epirubicin
  • Capecitabine
  • Irinotecan
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Cisplatin
  • Fluorouracil

Grants and funding