Journal of Clinical Oncology, 2008 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 26, No 15S (May 20 Supplement), 2008: 15082
© 2008 American Society of Clinical Oncology

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Abstract

Longitudinal patterns of chemotherapy (CT) use in metastatic colorectal cancer (mCRC)

Duke University Medical Center, Durham, NC

15082

Background: As mCRC survival increases beyond 2 years, patients (pts) have more exposure to multiple CT regimens. Insight into patterns of care in mCRC treatment is crucial to understanding physician and patient decision-making priorities. Methods: Using a population-based strategy, we identified CRC cases from 1 academic and 9 community oncology practices in the southeastern US with mCRC diagnosed between 6/03–6/06, and treatment with an oxaliplatin- (O) or irinotecan- (IR) based CT regimen during that period. Demographic, disease, treatment, and toxicity data were abstracted by retrospective chart review, double-entered and verified for accuracy. Results: Of 743 charts screened, 110 were eligible: mean age 57.9 (SD 12.2), 74% Stage IV at diagnosis, 39% male, 53% white, 26% black, and 13% 70 years. As part of 1st-line mCRC CT, 100% of pts received regimens containing 5-fluorouracil (5-FU), 87% (95% CI 81–93%) received O, 12% (95% CI 6–18%) received IR, and 74% (95% CI 66–82%) received bevacizumab (B). The proportions of pts receiving subsequent lines of CT were: 2nd-line 48% (n=53), 3rd-line 26% (n=29), 4th-line 14% (n=15), and 5th-line 5% (n=5). From 1st to 3rd line, the use of O and B decreased, while IR use increased (see Table). Therapy was discontinued 29% of the time for disease progression (PD) and 19% of the time for toxicity; 27% had no reason documented. 22% (n=25/114) of O- and 34% (n=20/59) of IR-containing regimens were discontinued for PD. 19% (n=21/114) of O- and 20% (n=12/59) of IR-containing regimens were discontinued for toxicity. Conclusions: Along with 5-FU, O and B were most commonly used in 1st-line for mCRC. Use of O decreased and IR increased as treatment progressed beyond 1st-line.

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