A global perspective in second‐line treatment patterns for patients with advanced esophageal squamous cell carcinoma. Issue 9 (30th March 2022)

• Record Type: Journal Article
• Authors: Jaffe, Dena H.; Gricar, Joseph; DeCongelio, Marc; Mackie, deMauri S.
• Is Part Of: Thoracic cancer. Volume 13:Issue 9(2022)
• Page Start: 1240
• Page End: 1257
• Publication Date: 2022-03-30
• Subjects: advanced ESCC -- Esophageal cancer -- healthcare resource utilization -- second‐line -- treatment patterns; Chest -- Cancer -- Periodicals; Chest -- Cancer -- Treatment -- Periodicals; Chest -- Surgery -- Periodicals; 616.99494005
• DOI: 10.1111/1759-7714.14334
• Languages: English
• ISSNs: 1759-7706

Abstract

Abstract: Background: 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. Methods: 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. Results: 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. Conclusions: While regional variations were observed throughout the course of a patient's advESCC journey, disease response and treatment outcomes were similar. Abstract : Taxanes represented the most commonly used systemic therapy for the second‐line (2L) treatment of advanced ESCC in most Asian and western countries. Significantly higher rates of 2L treatment‐related healthcare resource utilization were observed in patients from Asia than the West. No statistically significant regional differences were reported for response to 2L or outcomes prior to 3L. A global retrospective study of second‐line treatment patterns for patients with advanced esophageal squamous cell carcinoma