File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Real‐world treatment patterns and outcomes in refractory metastatic colorectal cancer

TitleReal‐world treatment patterns and outcomes in refractory metastatic colorectal cancer
Authors
Keywordsmetastatic colorectal cancer
palliative care
refractory
regorafenib
trifluridine/tipiracil (TAS-102)
Issue Date2019
PublisherWiley-Blackwell Publishing Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1743-7563
Citation
Asia-Pacific Journal of Clinical Oncology, 2019, v. 15 n. S2, p. 5-13 How to Cite?
AbstractAim: To investigate treatment patterns and outcomes of metastatic colorectal cancer (mCRC) patients beyond second progression (PD2) since regorafenib and TAS-102 became available in Hong Kong. Methods: The clinical records of consecutive mCRC patients who were treated beyond PD2 at Department of Clinical Oncology, Queen Mary Hospital between June 2013 and February 2018, were retrospectively reviewed. Results: Of 176 PD2 patients (76.7% Eastern Cooperative Oncology Group performance status 0/1 and a median follow-up time of 6.6 [range, 0.4–37.2] months), 104 (59%) underwent palliative care only and 72 (41%) received active third-line (3L) treatment: regorafenib (n = 22), TAS-102 (n = 6), chemotherapy + antiepidermal growth factor receptor (n = 12), chemotherapy + antivascular endothelial growth factor (n = 28) or clinical trials (n = 4). Patients on active 3L treatment had significantly longer OS than those on palliative care only: 11.7 versus 5.5 months (adjusted hazard ratio = 0.41, 95% confidence interval: 0.28–0.61, P < 0.001). For those on active treatment, OS was significantly associated with the time from diagnosis of metastasis to PD2 (P < 0.001) and post-3L treatments (P = 0.009). When analyzing treatment eligibility according to trial criteria, half of the eligible patients (54/109) did not receive active treatment, but both eligible and ineligible patients achieved better OS when receiving active 3L treatment versus palliative care only (P < 0.001 and P = 0.002). No unexpected toxicity was reported. Conclusion: Active 3L and beyond treatment significantly prolonged OS versus palliative care, even in selected “trial ineligible” patients. Given a high rate of palliation only care in eligible patients, improved patient access to medicine and counseling may be needed to maximize outcomes. © 2019 John Wiley & Sons Australia, Ltd
Persistent Identifierhttp://hdl.handle.net/10722/275710
ISSN
2019 Impact Factor: 2.012
2015 SCImago Journal Rankings: 0.554
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChiang, CL-
dc.contributor.authorChoi, HC-
dc.contributor.authorLam, KO-
dc.contributor.authorChan, BY-
dc.contributor.authorLee, SF-
dc.contributor.authorYeung, SY-
dc.contributor.authorLau, KS-
dc.contributor.authorChan, SY-
dc.contributor.authorChoy, TS-
dc.contributor.authorYuen, KK-
dc.date.accessioned2019-09-10T02:48:05Z-
dc.date.available2019-09-10T02:48:05Z-
dc.date.issued2019-
dc.identifier.citationAsia-Pacific Journal of Clinical Oncology, 2019, v. 15 n. S2, p. 5-13-
dc.identifier.issn1743-7555-
dc.identifier.urihttp://hdl.handle.net/10722/275710-
dc.description.abstractAim: To investigate treatment patterns and outcomes of metastatic colorectal cancer (mCRC) patients beyond second progression (PD2) since regorafenib and TAS-102 became available in Hong Kong. Methods: The clinical records of consecutive mCRC patients who were treated beyond PD2 at Department of Clinical Oncology, Queen Mary Hospital between June 2013 and February 2018, were retrospectively reviewed. Results: Of 176 PD2 patients (76.7% Eastern Cooperative Oncology Group performance status 0/1 and a median follow-up time of 6.6 [range, 0.4–37.2] months), 104 (59%) underwent palliative care only and 72 (41%) received active third-line (3L) treatment: regorafenib (n = 22), TAS-102 (n = 6), chemotherapy + antiepidermal growth factor receptor (n = 12), chemotherapy + antivascular endothelial growth factor (n = 28) or clinical trials (n = 4). Patients on active 3L treatment had significantly longer OS than those on palliative care only: 11.7 versus 5.5 months (adjusted hazard ratio = 0.41, 95% confidence interval: 0.28–0.61, P < 0.001). For those on active treatment, OS was significantly associated with the time from diagnosis of metastasis to PD2 (P < 0.001) and post-3L treatments (P = 0.009). When analyzing treatment eligibility according to trial criteria, half of the eligible patients (54/109) did not receive active treatment, but both eligible and ineligible patients achieved better OS when receiving active 3L treatment versus palliative care only (P < 0.001 and P = 0.002). No unexpected toxicity was reported. Conclusion: Active 3L and beyond treatment significantly prolonged OS versus palliative care, even in selected “trial ineligible” patients. Given a high rate of palliation only care in eligible patients, improved patient access to medicine and counseling may be needed to maximize outcomes. © 2019 John Wiley & Sons Australia, Ltd-
dc.languageeng-
dc.publisherWiley-Blackwell Publishing Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1743-7563-
dc.relation.ispartofAsia-Pacific Journal of Clinical Oncology-
dc.rightsPreprint This is the pre-peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Postprint This is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.-
dc.subjectmetastatic colorectal cancer-
dc.subjectpalliative care-
dc.subjectrefractory-
dc.subjectregorafenib-
dc.subjecttrifluridine/tipiracil (TAS-102)-
dc.titleReal‐world treatment patterns and outcomes in refractory metastatic colorectal cancer-
dc.typeArticle-
dc.identifier.emailChiang, CL: chiangcl@hku.hk-
dc.identifier.emailLam, KO: lamkaon@hku.hk-
dc.identifier.authorityChiang, CL=rp02241-
dc.identifier.authorityLam, KO=rp01501-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1111/ajco.13114-
dc.identifier.scopuseid_2-s2.0-85063078728-
dc.identifier.hkuros303028-
dc.identifier.volume15-
dc.identifier.issueS2-
dc.identifier.spage5-
dc.identifier.epage13-
dc.identifier.isiWOS:000462609500001-
dc.publisher.placeUnited Kingdom-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats