Real-World Unmet Needs in Patients With HER2-Negative Advanced Gastric, Gastro-Esophageal or Esophageal Adenocarcinoma Receiving First-Line Treatment Globally

Author(s)

Jaffer Ajani, MD1, Florian Lordick, MD2, Jin Gu, PhD3, Daniel Koralek, PhD3, Shivani Mhatre, PhD3, Cosmina Hogea, PhD3, Annabel Lambert, MS4, Alex Busby, MS4, Naureen Starling, PhD5.
1MD Anderson Cancer Center, Houston, TX, USA, 2University of Leipzig Medical Center, Leipzig, Germany, 3Gilead Sciences, Foster City, CA, USA, 4Adelphi Real World, Bollington, United Kingdom, 5Royal Marsden Hospital, London, United Kingdom.
OBJECTIVES: To describe real-world treatment-related effects in patients with HER2-negative advanced (stage IIIA-IVB) gastric/gastroesophageal junction/esophageal adenocarcinoma (GC/GEJC/EAC) treated with first-line (1L) chemotherapy alone or chemotherapy plus immune checkpoint inhibitors (chemotherapy+ICI).
METHODS: Data were extracted from the Adelphi Real World Gastric Cancer Disease Specific Programme™, a cross-sectional survey, with retrospective data collection via medical chart review, of physicians and patients with advanced HER2-negative GC/GEJC/EAC in the United States, United Kingdom, Europe and Asia, from October 2022-September 2024. Patients were on 1L or second-line and beyond (2L+) treatment for advanced cancer at data collection. Physicians reported patient demographics, clinical characteristics and adverse events (AEs) for patients receiving 1L treatment from medical charts; patients self-reported AEs. For patients on 2L+ treatment, treatment duration and response on 1L was reported. Analyses presented here are descriptive.
RESULTS: Overall, 450 physicians provided data on 1623 patients on 1L (n=551 chemotherapy only; n=389 chemotherapy+ICI) and 643 patients on 2L+. AEs were reported for 47% and 38% of patients receiving 1L chemotherapy only and chemotherapy+ICI, respectively; commonly nausea (52%/46%) and diarrhea (22%/29%). Discrepancies were observed in most of physician-patient reported AEs; for instance, sleep disturbance was reported by 80%/72% of patients (chemotherapy only/chemotherapy+ICI) compared to only 7%/5% of physicians. Dose change was reported for 13%/14% of patients, mostly due to unacceptable tolerability (90%/89%). In the 2L+ treatment group [1L chemotherapy alone (n=311) or chemotherapy+ICI (n=74)], mean (SD) treatment duration was 6.2(3.2)/7.5(5.8) months, with complete or partial response experienced by 49% and 56% of patients, respectively.
CONCLUSIONS: In both treatment groups around half of patients experienced a complete or partial response and common AEs; indicating a need for novel treatments with improved response, and a safety profile that does not increase side effect burden. Physician-patient disconnect regarding AE reporting was observed, emphasising the need for better physician-patient communication.

Conference/Value in Health Info

2025-05, ISPOR 2025, Montréal, Quebec, CA

Value in Health, Volume 28, Issue S1

Code

RWD11

Topic

Real World Data & Information Systems

Disease

SDC: Oncology

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