Tjulandin Sergei A, Tryakin Alexey A, Besova Natalia S, Sholokhova Evgeniya, Ivanova Jasmina I, Cheng Wendy Y, Schmerold Luke M, Thompson-Leduc Philippe, Novick Diego
N. N. Blokhin National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, Moscow, Russia.
Lilly Pharma, Moscow, Russia.
J Drug Assess. 2019 Sep 17;8(1):150-158. doi: 10.1080/21556660.2019.1669610. eCollection 2019.
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. 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. 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. 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.
关于一线治疗失败后的转移性和/或不可切除胃癌(mGC)患者的管理,目前可用的证据很少。本研究展示了俄罗斯mGC患者的特征和治疗模式的真实世界数据。符合条件的患者年龄≥18岁,于2012年1月1日及以后被诊断为mGC,接受一线化疗后接受二线化疗或最佳支持治疗(BSC),在开始二线化疗或BSC后有≥3个月的随访(死亡病例除外),且未参加过临床试验。数据采用描述性统计进行总结。共有88名医生提供了来自202份病历的数据。mGC诊断时的平均年龄为53.7岁(标准差:11.2);70.8%的患者为男性。一线治疗中断的原因包括疾病进展(50.5%)和不良事件/毒性(39.1%)。二线治疗中开出了52种独特的治疗方案;卡培他滨(14.5%)、紫杉醇(9.3%)和卡培他滨+奥沙利铂(8.7%)是最常用的。二线治疗中断的原因包括疾病进展(39.8%)和患者拒绝继续(37.5%)。在二线治疗期间,最常见的治疗相关症状是恶心/呕吐(75.0%),而疼痛(73.8%)是最常见的疾病相关症状。最常使用的支持治疗包括止吐药(63.4%)、化疗(61.6%)、非麻醉性镇痛药(48.3%)、内镜检查(45.9%)和营养支持(35.5%)。俄罗斯mGC患者的二线治疗模式各不相同。本研究结果表明,根据国际和国家指南,在mGC二线治疗中更积极地实施最有效的治疗方案很有必要。