Patterns of chemotherapy (CT) use in a U.S.-wide cohort of patients (pts) with metastatic gastric cancer (MGC).

Abstract

112 Background: MGC is associated with poor survival outcomes. Despite multiple therapeutic options, there is no clearly defined standard-of-care (SOC) CT algorithm. Assessing MGC treatment trends of CT utilization is of critical import. Few population studies have examined the frequencies and temporal trends of MGC CT regimens. This study was designed to address this knowledge deficit. Methods: Eligible pts had biopsy-proven MGC diagnoses and received CT between Jan 2005 and Dec 2016 at academic, private or community hospital practices using IntrinsiQ, a US-wide CT order entry system that captures pt, provider and CT data. Temporal trends were analyzed in the context of SOC changes during the study’s observational period. Results: Among 4,333 MGC pts, median age was 64; 74% were male. In 1st-line CT, 26% received fluoropyrimidine [FU] + oxaliplatin (FOLFOX), 15% received epirubicin + platinum + FU [ECF/EOX], 15% received docetaxel (D) + cis/carboplatin (C) + FU [DCF], 13% received C + paclitaxel, 10% received C + FU [CF], 5% received taxane [TAX] monotherapy. FOLFOX use has increased steadily to 41% in 2015 while DCF use dropped from 29% in 2007 to below 10% by 2015. Biologics were used in 11% of all 1st-line starts and 24% of all 2nd-line starts. Trastuzumab represented 72% of 1st line biologic use (with or without CT backbones), overall use increased from 0% in 2008 to 16% of 1st line in 2015 In 2nd line, no single treatment regimen was used in more than 7% of patients in 2005, but the use of newer treatments has increased over time: trastuzumab use increased from 0% in 2008 to a peak of 22% in 2016 and ramucirumab use increased from 0% in 2012 to its peak in 2015 of 26%. Conclusions: This population-based study provides insight into US MGC treatment patterns and recent trends with the availability of novel agents. [Table: see text]