P-0172 Distribution of Kras Status Across Treatment Patterns In 1st and 2nd Line Metastatic Colorectal Cancer (MCRC) Patients in Western Europe

Abstract

ABSTRACT Introduction Treatment guidelines, including ESMO, emphasize the importance of testing KRAS status prior to selecting optimal therapy for mCRC patients and recommend the use of anti-EGFR antibodies only for KRAS wild-type patients. This study evaluates adherence to guidelines and describes the use of chemotherapy regimens and monoclonal antibodies (mabs) in 1st (1L) and 2nd line (2L) by KRAS status in Germany, Spain, Italy, France and United Kingdom (UK). Methods Using physician survey data from Oncology Analyzer databaseTM in five European countries, treatment regimens for 1L and 2L mCRC patients were assessed. Patients ≥21 years of age diagnosed with mCRC and treated between January 2009 and December 2010 undergoing chemotherapy and who were not in clinical trials were included in the study. Results 4919 patients were identified in 1L and 2L with median age category of 61-65 yrs. 3937 patients were identified in 1L with 42% known and 58% unknown KRAS status. Among those with KRAS status, 18% were mutant, and 24% were wild type. In 2L, 982 patients were identified, with 53.6% known and 46.4% unknown KRAS status. Among those with KRAS status, 21.5% were mutant, 32.1% were wild type. In 1L, 48.3% of KRAS mutant patients received a bevacizumab-containing regimen in comparison to 32.2% and 22.5% for KRAS wild type and unknown patients, respectively. Cetuximab-containing regimens were mainly used for wild-type patients in 1L (34.6% versus 1.3% and 2.1% for mutant and unknown, respectively). In 2L, 42.2% of KRAS mutant patients received bevacizumab-containing regimens versus 20.6% for wild type and 23.9% for unknown patients. KRAS wild-type patients were more likely to receive cetuximab-containing regimens in 2L (50.5% of patients versus 3.8% and 6.4% for mutant and unknown, respectively). Across 1L and 2L, 88.9% of patients in the UK were not tested for KRAS status, while the range for Germany, Spain Italy and France was 41-56%. The top 3 regimens by KRAS status are shown in the table below: Conclusion Mabs are routinely combined with chemotherapy in the treatment of mCRC, which is consistent with treatment guidelines. Bevacizumab containing regimens were common across all KRAS categories in both 1L and 2L. Overall, cetuximab use was observed only in KRAS wild-type patients across both lines. Continued KRAS testing should be implemented stringently in the EU, especially in the UK, to obtain more informed KRAS dependent data on current treatment patterns for mCRC patients. Table 1 .