Utilisation of systemic therapy options in routine treatment of metastatic colorectal cancer in Australia

Abstract

Background In the treatment of metastatic colorectal cancer (mCRC), exposure to all three active cytotoxic agents, 5‐fluorouracil/capecitabine, irinotecan and oxaliplatin, improves overall survival. The addition of biologic agents (bevacizumab and cetuximab/panitumumab) further improves survival. The uptake of available systemic agents for mCRC in routine practice in Australia is poorly described. Methods The ACCORD database was interrogated to determine demographics, treatments and outcomes for patients diagnosed with mCRC between 1 January 2011 and 1 January 2016 at six Melbourne centres. Results About 1130 mCRC patients were identified: median age was 69 years (range 26–105); 61% had synchronous disease. KRAS status was known in 62%, of whom 49% were KRAS wild‐type. At the time of analysis, 67% of all patients had commenced systemic treatment, 50% had received two or more lines of therapy and 19% of KRAS wild‐type patients had received all five active drugs. Of KRAS‐mutated patients, 35% had received all four Pharmaceutical Benefits Scheme–reimbursed active drugs. Patients who had not received chemotherapy included 72 patients who underwent metastasectomy alone. At a median follow up of 34 months, median overall survival was 25 months for all patients and 69 months for those who underwent metastasectomy. Conclusion In this community‐based cohort, 33% of patients had not received any systemic therapy for mCRC, and few patients had received all available active systemic agents. As many patients remain alive, these figures will likely increase over time. The overall survival of patients with mCRC in this community‐based cohort was 25 months and not dissimilar to that achieved in recent clinical trials.

Survey on Mental Health Status and Quality of Life and Correlation among Patients with Permanent Stoma of Colorectal Tumor

“…Colorectal cancer is a common clinical malignant tumor of the digestive system, among which rectal cancer is the most common one, accounting for about 50%~60%, and low rectal cancer is more common in rectal cancer [ 1 ]. According to the World Health Organization, the incidence of colorectal cancer ranks third in the incidence of malignant tumors [ 2 ].…”