ISPOR Real-World Evidence Summit 2025
28-30 September
Presentation
Advancing Colorectal Cancer (CRC) Research in Japan: Insights From Electronic Health Record (EHR)-Derived Data in Japan
Author(s)
Hideaki Bando, MD, PhD1, Dionne Ng, BA2, Eri Tajima, MS2, Blythe Adamson, PhD, MPH3.
1Department for the Promotion of Drug and Diagnostic Development, National Cancer Center Hospital East, Kashiwa, Japan, 2Flatiron Health K.K., Tokyo, Japan, 3Flatiron Health, New York, NY, USA.
1Department for the Promotion of Drug and Diagnostic Development, National Cancer Center Hospital East, Kashiwa, Japan, 2Flatiron Health K.K., Tokyo, Japan, 3Flatiron Health, New York, NY, USA.
Presentation Documents
OBJECTIVES: Understanding real-world patient characteristics, treatment patterns, and outcomes for CRC in Japan has been limited by the lack of comprehensive, recent, and longitudinal data. EHR-derived datasets provide a unique opportunity to address existing gaps in capturing heterogeneity among real-world populations. Using an EHR-derived dataset, we examined patient clinical and demographic characteristics and biomarker testing rates in a real-world Japanese cohort.
METHODS: We evaluated a CRC dataset from the Japan Flatiron Health Research Database, a database derived from structured and unstructured data documented in EHRs during routine oncology care in Japan, and curated through technology-enabled abstraction and manual review. Patients diagnosed with CRC on or after January 1, 2015 were included (data cutoff: September 30, 2024).
RESULTS: Of 629 patients diagnosed with CRC, 22% were diagnosed before age 50 years, and 57% were diagnosed on or after January 1, 2020. Of patients with a documented disease site (>99%), 44% had disease in the left colon, 30% in the right colon, and 25% in the rectum. Among patients with available data, 96% had an ECOG performance status score of ≤2 at first treatment. Biomarker testing rates were high for KRAS (90%), NRAS (87%), and BRAF (77%) and lower for microsatellite instability (56%), mismatch repair (34%), and HER2 (32%). Biomarker positivity rates were consistent with previous reports, with higher KRAS positivity among patients with right-sided (53%) vs left-sided (37%) disease. Among 371 patients with de novo metastatic disease, 40% received primary surgery. Of 549 patients with metastatic disease, 76% experienced real-world progression within 2 years of diagnosis.
CONCLUSIONS: This study revealed variability in clinical characteristics and biomarker testing among patients diagnosed with CRC in Japan, thereby highlighting opportunities to optimize care and align practices with clinical guidelines. Further research using EHR-derived datasets is crucial in advancing CRC research and informing healthcare decision making in Japan.
METHODS: We evaluated a CRC dataset from the Japan Flatiron Health Research Database, a database derived from structured and unstructured data documented in EHRs during routine oncology care in Japan, and curated through technology-enabled abstraction and manual review. Patients diagnosed with CRC on or after January 1, 2015 were included (data cutoff: September 30, 2024).
RESULTS: Of 629 patients diagnosed with CRC, 22% were diagnosed before age 50 years, and 57% were diagnosed on or after January 1, 2020. Of patients with a documented disease site (>99%), 44% had disease in the left colon, 30% in the right colon, and 25% in the rectum. Among patients with available data, 96% had an ECOG performance status score of ≤2 at first treatment. Biomarker testing rates were high for KRAS (90%), NRAS (87%), and BRAF (77%) and lower for microsatellite instability (56%), mismatch repair (34%), and HER2 (32%). Biomarker positivity rates were consistent with previous reports, with higher KRAS positivity among patients with right-sided (53%) vs left-sided (37%) disease. Among 371 patients with de novo metastatic disease, 40% received primary surgery. Of 549 patients with metastatic disease, 76% experienced real-world progression within 2 years of diagnosis.
CONCLUSIONS: This study revealed variability in clinical characteristics and biomarker testing among patients diagnosed with CRC in Japan, thereby highlighting opportunities to optimize care and align practices with clinical guidelines. Further research using EHR-derived datasets is crucial in advancing CRC research and informing healthcare decision making in Japan.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD239
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Oncology