PCN233 - Description of First-Line Treatments in Patients with Non-Resectable Colorectal Cancers in Belgium

Abstract

Treatment protocols/ guidelines (cf. ESMO) recommend the use of fluoropyrimidine-containing combination chemotherapy regimens as first-line treatment in patients with non-resectable/ metastatic colorectal cancers (mCRC). However, there is a paucity of real-life data regarding the chemotherapies that are effectively administered to these patients in Belgium. This study aimed at identifying first line combination chemotherapy treatments administered to patients with mCRC in Belgium. This study was conducted using the longitudinal IMS RWD Hospital Data -Belgium database (years 2013-2014), including data (diagnoses, procedures, detailed information on in-hospital drug treatments, patient demographics) on 25% of Belgian hospital beds. The eligible population was selected based on ICD-9-CM diagnosis codes for colorectal cancers (153, 154, excluding anal cancers – 154.2, 154.3) associated with a concomitant diagnosis code for metastasis (196-198, excluding 196.2 – metastasis to intra-abdominal lymph nodes). Follow-up period extended from first mCRC diagnosis until last observation in the database (cut-off date: December 31st 2014). Chemotherapy sessions were identified through presence of a diagnosis code for chemotherapy administration (V58.1) or documented administration of a chemotherapeutical agent. A total of 1,803 mCRC patients were retrieved in the data (average age: 70.2 years; 58.7% male). About 30% (n=548) were treated in first line with a combination therapy; these patients were significantly younger than the rest of the sample (65.7 vs. 72.1 years; p<0.001). Among those receiving a first line combination therapy, 26.6% (n=146) received fluoropyrimidines (5-FU or capecitabine) in combination with oxaliplatin, 6.2% (n=34) in combination with irinotecan, 19.9% (n=109) in combination with a monoclonal antibody and 45.3% (n=248) in combination with a monoclonal antibody and oxaliplatin or irinotecan. Even though a combination therapy is preferred in the treatment of mCRC, this Belgian real-life practice study shows that less than a third of the patients receive it.