Desai K, Amonkar M, Jain R, Patton G, Estenson K, Sartaj A, Cosgrove D, Sura S
Outcomes Research, Oncology, Merck & Co.Inc, Rahway, NJ, USA.
Oncology Clinical Development, Merck & Co.Inc, Rahway, NJ, USA.
Future Oncol. 2025 Jul;21(16):2027-2037. doi: 10.1080/14796694.2025.2504246. Epub 2025 May 15.
To assess biomarker testing utilization, treatment patterns, and clinical outcomes in previously treated proficient mismatch repair deficient (pMMR) or non-microsatellite instability-high (MSI-H) metastatic colorectal cancer (mCRC) patients.
MATERIALS & METHODS: Using the iKnowMed electronic health record database, this study included pMMR/non-MSI-H adult mCRC patients previously treated with standard-of-care (SoC) chemotherapies between 1 January 2016 and 31 December 2021. Patients were censored for overall survival (OS) and real-world progression-free survival (rwPFS) at their last visit date or the end of study period, 31 August 2022.
MSI/MMR testing was conducted in 70.9% of mCRC patients. In 292 previously treated mCRC patients, 69.5% received SACT (regorafenib:14.8%, trifluridine+tipiracil (TAS-102):12.3%, other SACT:72.9%), 28.8% received BSC and 1.7% received no BSC/SACT. The most common other SACT included irinotecan- (37.4%) and oxaliplatin-based (14.8%) therapies. The most patients were tested for KRAS (89%) and BRAF (81%). Overall, the median (95% CI) OS and rwPFS was 7.4(5.8,8.8) and 3.5(3.2,4.3) months, respectively.
Only 70.9% of mCRC patients received guideline-recommended MSI/MMR testing, indicating a need for improved testing rates. Additionally, only 27.1% of previously treated mCRC patients received SoC options (regorafenib/TAS-102). The real-world variability in treatment choices and a high rate of chemotherapy rechallenge in subsequent lines highlight an unmet need in this patient population.
评估既往接受过治疗的错配修复缺陷熟练型（pMMR）或非微卫星高度不稳定（MSI-H）转移性结直肠癌（mCRC）患者的生物标志物检测应用情况、治疗模式及临床结局。
本研究使用iKnowMed电子健康记录数据库，纳入2016年1月1日至2021年12月31日期间接受过标准治疗（SoC）化疗的pMMR/非MSI-H成年mCRC患者。在患者最后一次就诊日期或研究结束日期（2022年8月31日）对其总生存期（OS）和真实世界无进展生存期（rwPFS）进行 censored（此处censored含义不明，暂保留英文）。
70.9%的mCRC患者进行了MSI/MMR检测。在292例既往接受过治疗的mCRC患者中，69.5%接受了全身抗癌治疗（SACT）（瑞戈非尼：14.8%，曲氟尿苷+替匹嘧啶（TAS-102）：12.3%，其他SACT：72.9%），28.8%接受了最佳支持治疗（BSC），1.7%未接受BSC/SACT。最常见的其他SACT包括基于伊立替康的治疗（37.4%）和基于奥沙利铂的治疗（14.8%）。大多数患者检测了KRAS（89%）和BRAF（81%）。总体而言，中位（95%CI）OS和rwPFS分别为7.4（5.8，8.8）个月和3.5（3.2，4.3）个月。
仅70.9%的mCRC患者接受了指南推荐的MSI/MMR检测，表明检测率有待提高。此外，仅27.1%的既往接受过治疗的mCRC患者接受了SoC方案（瑞戈非尼/TAS-102）。治疗选择的真实世界变异性以及后续治疗线中较高的化疗再挑战率凸显了该患者群体中未满足的需求。
