Jaffe Dena H, Gricar Joseph, DeCongelio Marc, Mackie deMauri S
RWE, Cerner Enviza, Jerusalem, Israel.
WWHEOR, Bristol-Myers Squibb, Princeton, New Jersey, USA.
Thorac Cancer. 2022 May;13(9):1240-1257. doi: 10.1111/1759-7714.14334. Epub 2022 Mar 30.
Esophageal cancer is a highly prevalent cancer associated with low survival, especially among those with advanced disease. Second-line (2L) treatment patterns and related clinical outcomes of patients with advanced esophageal squamous cell carcinoma (advESCC) treated in routine clinical care were examined globally and regionally.
A retrospective, noninterventional study collected physician-provided chart data of patients aged ≥20 years receiving either 2L active systemic therapy or BSC following first-line active therapy for advESCC from 11 countries in Asian and Western regions (September-October 2018). Bivariate analyses examined treatment and outcomes by region.
AdvESCC patients (Asia = 192; West = 195) were examined, of which 58.1% (Asia n = 101; West n = 124) received active systemic therapy. While regional differences in tumor classification and staging at diagnosis were observed with less advanced tumors in Asia, no regional differences for these characteristics at 2L initiation were reported. Both taxane- and nontaxane-based therapies were used as 2L therapy among Asian and Western patients, although more western than Asian patients received immuno- or targeted therapies (17.0% vs. 3.0%; p = 0.001). Alopecia (10.7%), neutropenia (9.3%), and fatigue (9.3%) were the most-commonly reported adverse events (AEs) in both regions. Significantly higher 2L AE-related emergency room visits (Asia = 22.5% vs. West = 8.0%; p < 0.001) and hospitalizations (Asia = 25.9 ± 31.2 vs. West = 4.7 ± 7.0, p < 0.001) were observed in Asian than in Western patients. No regional differences were reported for response to 2L treatment or the percent of patients who received third-line treatment/died.
While regional variations were observed throughout the course of a patient's advESCC journey, disease response and treatment outcomes were similar.
食管癌是一种高发性癌症，生存率较低，尤其是晚期患者。本研究对全球和地区范围内接受常规临床治疗的晚期食管鳞状细胞癌（advESCC）患者的二线（2L）治疗模式及相关临床结局进行了分析。
这是一项回顾性、非干预性研究，收集了2018年9月至10月期间亚洲和西部地区11个国家中年龄≥20岁、接受一线积极治疗后接受2L积极全身治疗或最佳支持治疗（BSC）的advESCC患者的医生提供的病历数据。采用双变量分析按地区检查治疗和结局。
共纳入了advESCC患者（亚洲=192例；西方=195例），其中58.1%（亚洲n = 101例；西方n = 124例）接受了积极全身治疗。虽然在诊断时观察到肿瘤分类和分期存在地区差异，亚洲的肿瘤进展程度较低，但在开始2L治疗时这些特征无地区差异。亚洲和西方患者均使用紫杉烷类和非紫杉烷类疗法作为2L治疗，不过接受免疫治疗或靶向治疗的西方患者多于亚洲患者（17.0%对3.0%；p = 0.001）。脱发（10.7%）、中性粒细胞减少（9.3%）和疲劳（9.3%）是两个地区最常报告的不良事件（AE）。与2L AE相关的急诊就诊率（亚洲=22.5%对西方=8.0%；p < 0.001）和住院率（亚洲=25.9 ± 31.2对西方=4.7 ± 7.0，p < 0.001）在亚洲患者中显著高于西方患者。2L治疗反应或接受三线治疗/死亡患者的百分比无地区差异。
虽然在患者的advESCC病程中观察到地区差异，但疾病反应和治疗结局相似。
