PCN352 Treatment Patterns and Performance Status in Unresectable Advanced or Metastatic (ADV/MET) Gastric Cancer (GC), Gastroesophageal Junction Cancer (GEJC) and Esophageal Adenocarcinoma (EAC) Patients Receiving First LINE (1L) Treatment

Abstract

Patients with ADV/MET GC, GEJC and EAC and poor performance status have a dismal prognosis. Performance status at diagnosis may influence 1L treatment. Our study explored performance status and current 1L treatment patterns in patients with ADV/MET GC, GEJC and EAC. A cross-sectional survey was conducted in France, Germany, the UK, the US, Japan and China (Apr–Oct 2019) of patients with ADV/MET GC, GEJC and EAC and their physicians. Significance testing was conducted using Fisher’s Exact tests. Of 995 patients included, 990 had Eastern Cooperative Oncology Group Performance Status (ECOG PS) at ADV/MET diagnosis (0-1: 74%, 2+:26%). Of these 990 patients, 867 (88%) received active 1L systemic therapy and 123 (12%) received only Best Supportive Care (BSC). Of the 867 patients on active 1L therapy, 5%, 44% and 29% received mono, doublet and triplet chemotherapy, respectively, while 15% received trastuzumab-based regimens. Most patients on mono chemotherapy (n=42) received a fluoropyrimidine (Fp; 86%), most patients on doublet chemotherapy (n=382) received a Fp and platinum (Pt) doublet (85%). Most patients on triplet chemotherapy (n=253) received Fp, Pt and anthracycline (53%) or taxane (40%) regimens. Patients receiving active 1L treatment had better ECOG PS at adv/met diagnosis (0-1: 88%, 2+: 22%) than those receiving only BSC ( 0-1: 47%, 2+: 53%; p<.0001). Among patients on active 1L treatment with negative, unknown or untested HER-2 status with reported ECOG PS on active 1L chemotherapy treatment (n=623), the proportion with ECOG PS 0-1 at ADV/MET diagnosis was 70%, 76% and 81% for patients receiving mono (n=37), doublet (n=349) and triplet (n=237) chemotherapy, respectively. A relationship was found between ECOG PS at ADV/MET diagnosis and treatment type, with a higher proportion of patients on BSC only having poor (2+) performance status, compared with patients on active 1L systemic therapy.