Gastric cancer (GC) [including gastroesophageal junction cancer (GEJC)] has the second highest incidence and third highest mortality rate of all malignancies in China. For patients diagnosed with unresectable advanced or metastatic (UAM) GC, the prognosis and survival outcomes are extremely poor.
This was a retrospective real-world observational study using an oncology database operated by Digital China Health (DCH), which is comprehensive electronic health record (EHR) repository of patient demographics, clinical (including imaging, pathology.), medication use, healthcare resource use (HCRU) and cost data. Patients having ≥2 inpatient records with a primary ICD-10 code of GC were selected from Jan 1st, 2012 through Dec 31st, 2018. The first date of inpatient admission was defined as the index date. Patients were followed for a minimum ± 30 days from the index date and were stratified as resectable vs. unresectable advanced or metastatic (UAM). Demographics, clinical parameters, medication utilization, HCRU, and costs incurred were tracked for these cohorts.
A total of 7,464 patients met the inclusion/exclusion criteria, of whom 14.1% (n=1056) had UAM GC. The mean age at index date of patients with UAM GC was 57.7 (SD=11.3) years, with the vast majority male (70.5%). 69.3% (n=732) of patients with UAM GC received first line (1L) chemotherapy, the most frequent being S-1 + oxaliplatin (SOX, 22.7%) fluorouracil + oxaliplatin (FOLFOX, 12.6%) and capecitabine + oxaliplatin (XELOX, 11.2%). The average duration of 1L chemotherapy was 133.8 ± 115.9 days. Of these 1L line patients, 29.5% (n=216) went on to 2L treatment and 25.9 % (n=56) of 2L patients received 3L treatment. The main disease complications due to UAM GC were gastro-intestinal obstructions (7.8%) and ascites (7.5%). The main adverse drug events due to treatment were anemia (45.6%) and liver impairment (41.1%).
The majority of patients with UAM GC received 1L treatment. The top three regimens were SOX, FOLFOX and XELOX which seems consistent with Chinese Society of Clinical Oncology (CSCO) GC treatment guidelines.
Bristol-Myers Squibb Pharmaceutical Corp.
Bristol-Myers Squibb Pharmaceutical Corp.
X. Sun, Y. Qu: Research grant/Funding (self): Bristol-Myers Squibb. P. Navaratnam, H.S. Friedman: Research grant/Funding (self): Bristol-Myers Squibb. J. Gricar, H. Xiao: Shareholder/Stockholder/Stock options, Full/Part-time employment: Bristol-Myers Squibb.