TITLE:
Treatment Patterns and Economic Assessment of Systemic Therapy for Metastatic Colorectal Cancer
AUTHORS:
Thomas H. Cartwright, Lonnie K. Wen, Robyn K. Harrell, Patricia S. Fox, Janet L. Espirito, Ed Wang
KEYWORDS:
Metastatic Colorectal Cancer, Economic Assessment, Systemic Therapy, Treatment Patterns
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.7 No.9,
September
12,
2016
ABSTRACT: Introduction: Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the
third leading cause of cancer deaths in the United States. The goal of this
study was to understand treatment patterns, biomarker testing practices,
treatment adherence, and the clinical and economic outcomes associated with
chemotherapy for metastatic disease. Methods and Materials: We
retrospectively examined electronic health records of patients with metastatic
CRC who initiated chemotherapy between 01 January 2007 and 30 June 2011, with
follow-up to 30 June 2012. Parameters analyzed included demographics and
clinical characteristics, treatment patterns, clinical outcomes, and health
care resource utilization. Results: In the analysis, 756 patients were
included; median age was 61 years (55% male) at start of first line therapy.
The most commonly used regimens in the first, second, and third line were
FOLFOX + bevacizumab (46%), FOLFIRI +
bevacizumab (23%), and irinotecan + cetuximab (23%) respectively. Adherence to
guidelines decreased with increasing line of therapy. When assessed by
treatment backbone categories in the third line, outcome measures including
overall survival (OS), and time to treatment discontinuation (TTD) were not
statistically different between groups. In the multivariable model, body mass
index (BMI), performance status, and KRAS were significant predictors of
survival. Conclusions: This study provides insight into patterns of care
and outcomes of mCRC patients for the aforementioned time period. As treatment
options for mCRC evolve, it is valuable to understand the continuum of care to
help inform future treatment among candidates for continued therapy.