Real World Treatment Patterns In Metastatic And/Or Unresectable Gastric Cancer Patients In Russia

Abstract

Little evidence is available on the management of patients with metastatic and/or unresectable gastric cancer (mGC) after failure of 1st-line treatment. This study presents real-world data on patient characteristics and treatment patterns for these patients in Russia. Eligible patients were ≥18 years old, diagnosed with mGC on or after January 1, 2012, had received 1st-line chemotherapy including platinum analogue/fluoropyrimidine followed by 2nd-line chemotherapy or best supportive care (BSC), had ≥3 months of follow-up after the start of 2nd-line chemotherapy or BSC (except in cases of death), and had not participated in a clinical trial. Data were obtained from the patients’ charts, and summarized using descriptive statistics. Data from 202 charts were collected. Mean age was 53.7 (standard deviation [SD]: 11.2) years. 70.8% of patients were male. ECOG performance status (PS) at the start of 1st-line therapy was 15.5% PS=0, 58.3% PS=1, 16.7% PS=2, 8.9% PS=3. Reasons for 1st-line treatment discontinuation included disease progression (50.5%) and adverse events/toxicity (39.1%). There were 52 unique treatment regimens prescribed in 2nd-line; capecitabine (14.5%), paclitaxel (9.3%), and capecitabine+oxaliplatin (8.7%) were the most frequent. Reasons for 2nd-line treatment discontinuation included disease progression (39.8%) and patient refusal to continue (37.5%). During 2nd-line treatment, the most common treatment-related symptoms were nausea/vomiting (75.0%), while pain (73.8 %) was the most common disease-related symptom. Antiemetics (63.4%), chemotherapy (61.6%), non-narcotic analgesics (48.3%), endoscopy (45.9%), and nutritional support (35.5%) were used as supportive care. Most patients were hospitalized at least once during 2nd-line treatment for drug administration (74.5%) or other cancer-related care (24.4%). Second-line treatment patterns for patients with mGC in Russia are highly heterogeneous. The results of this study indicate the need for more intensive implementation of the most active regimens in 2nd-line treatment of mGC according to international and national guidelines.