Real-world treatment patterns among patients with advanced gastric cancer in Russia: a chart review study

Abstract

Objective: Little evidence is available on the management of patients with metastatic and/or unresectable gastric cancer (mGC) after the failure of first-line treatment. This study presents real-world data on characteristics and treatment patterns of patients with mGC in Russia.Methods: Eligible patients were ≥18 years old, diagnosed with mGC ≥ January 1, 2012, received first-line chemotherapy followed by second-line chemotherapy or best supportive care (BSC), had ≥3 months of follow-up after the start of second-line chemotherapy or BSC (except in cases of death), and had not participated in a clinical trial. Data were summarized using descriptive statistics.Results: A total of 88 physicians provided data from 202 charts. Mean age at mGC diagnosis was 53.7 (standard deviation: 11.2) years; 70.8% of patients were male. Reasons for first-line treatment discontinuation included disease progression (50.5%) and adverse events/toxicity (39.1%). There were 52 unique treatment regimens prescribed in second-line; capecitabine (14.5%), paclitaxel (9.3%), and capecitabine + oxaliplatin (8.7%) were the most frequent. Reasons for second-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 most frequently used as supportive care.Conclusions: Second-line treatment patterns for patients with mGC in Russia are heterogeneous. Results of this study indicate the need for more intensive implementation of the most active regimens in second-line treatment of mGC according to international and national guidelines.

Daily practices in chemotherapy for advanced gastric or gastroesophageal junction adenocarcinoma: METESTOMAC French prospective cohort

“… 22 , 25 , 28 The HER2 status was determined in almost all of the patients in our cohort, in accordance with international recommendations; it was determined in only 42% and 46% of cases in the Russian and South Korean cohorts, respectively. 26 , 27 Cancers were HER2 positive in 23% of patients in our cohort, which is similar to rates in previous studies, ranging from 15% to 33%.…”

“…The distribution between gastric cancer and GEJ cancer in our cohort is similar to that reported by the Russian and South Korean real‐life cohorts 26,27 and that of randomised trials, which include between 69% and 88% of gastric cancers 22,25,28 . The HER2 status was determined in almost all of the patients in our cohort, in accordance with international recommendations; it was determined in only 42% and 46% of cases in the Russian and South Korean cohorts, respectively 26,27 . Cancers were HER2 positive in 23% of patients in our cohort, which is similar to rates in previous studies, ranging from 15% to 33%.…”

“…Our national prospective cohort study provides important information on the management in current practice. The distribution between gastric cancer and GEJ cancer in our cohort is similar to that reported by the Russian and South Korean real-life cohorts 26,27 and that of randomised trials, which include between 69% and 88% of gastric cancers. 22,25,28 The HER2 status was determined in almost all of the patients in our cohort, in accordance with international recommendations; it was determined in only 42% and 46% of cases in the Russian and South Korean cohorts, respectively.…”

“…French guidelines recommend the use of chemotherapy in the second line, depending on the first‐line treatment: Irinotecan, taxane, ramucirumab alone or in combination (not reimbursed in France). The most widely used second‐line chemotherapy in our study was FOLFIRI (45%), used more often than in the Russian (15%) and South Korean cohorts (19%) 26,27 . Platinum and taxanes were used in 18% and 14% of cases, respectively, as in the Russian cohort (19% and 14%), and more often than in the South Korean cohort (13% and 8%) 26,27 .…”

“…This distribution of chemotherapy regimens differs from those reported by the Russian and the South Korean cohorts, where FU alone was used in 17% and 19%, respectively, and taxane in 7% of cases in Russia. 26,27 The use of doublet or triplet therapy with taxane remained low in our cohort, probably due to the fact that these were recent standards at the time.…”