Real-world outcomes with second-line therapy in advanced esophageal squamous cell carcinoma using SEER-Medicare data

Future Oncol. 2022 Mar;18(8):927-936. doi: 10.2217/fon-2021-0460. Epub 2022 Jan 27.

Abstract

Aim: To characterize real-world patterns of second-line treatment and outcomes in older patients with advanced/metastatic esophageal squamous cell carcinoma (ESCC). Patients and methods: Patients aged ≥66 years diagnosed with advanced/metastatic ESCC between 2010 and 2015 and followed through 2016 were included in this retrospective analysis using SEER-Medicare data. Results: Of 756 patients with advanced/metastatic ESCC, 104 (14%) received second-line therapy; median duration of treatment was 1.5 months. Median overall survival was 5.7 months for all patients receiving second-line treatment, and 4.5, 5.6 and 8.5 months, respectively, for patients receiving taxane monotherapy, taxane combination therapy and nontaxane therapy. Conclusion: A small proportion of patients with advanced/metastatic ESCC received second-line therapy, which was associated with short duration of treatment and poor overall survival.

Keywords: esophageal squamous cell carcinoma; locally advanced; overall survival; recurrent or metastatic; second line; treatment patterns; unresectable.

Plain language summary

This study assessed how US physicians have been treating a common type of esophageal cancer, known as squamous cell carcinoma, which has spread from the esophagus to other parts of the body (advanced/metastatic cancer). We looked at information from US cancer registry data on 756 people who were 66 years and older and diagnosed between 2010 and 2015. Only 14% of people received a second kind of chemotherapy after their first chemotherapy was stopped. People received their second chemotherapy for a short period (approximately 6 weeks) and lived for approximately 6 months on average from start of treatment. This research highlights that more effective treatments are needed for older people with advanced/metastatic esophageal squamous cell carcinoma.

MeSH terms

  • Aged
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / therapeutic use*
  • Bridged-Ring Compounds / administration & dosage
  • Bridged-Ring Compounds / therapeutic use*
  • Esophageal Neoplasms / drug therapy*
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / pathology
  • Esophageal Squamous Cell Carcinoma / drug therapy*
  • Esophageal Squamous Cell Carcinoma / mortality
  • Esophageal Squamous Cell Carcinoma / secondary
  • Female
  • Humans
  • Male
  • Medicare
  • Neoplasm Metastasis
  • Proportional Hazards Models
  • Retrospective Studies
  • SEER Program
  • Taxoids / administration & dosage
  • Taxoids / therapeutic use*
  • United States

Substances

  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Bridged-Ring Compounds
  • Taxoids
  • taxane

Grants and funding