K2GC: Real-world Treatments and Outcomes Amongst Patients With Resectable Gastric (GC) and Gastroesophageal Junction Cancer (GEJC) in the United States (US)
Author(s)
Leonardo Passos Chaves, MD1, Michael Baglio, Pharm.D2, Vishal Patel, MSc3, Pooja Gupta, Pharm.D4, Di He, PhD5, Niamh Hogan, MD6, Heide Stirnadel-Farrant, PhD3.
1Oncology Outcomes Research, AstraZeneca, Gaithersburg, MD, USA, 2US Medical Affairs, AstraZeneca, Gaithersburg, MD, USA, 3Oncology Outcomes Research, AstraZeneca, Cambridge, United Kingdom, 4US Medical Affairs, AstraZeneca, New York, NY, USA, 5Global Oncology Data & Analytics, AstraZeneca, Gaithersburg, MD, USA, 6Global Medical Affairs, AstraZeneca, Cambridge, United Kingdom.
1Oncology Outcomes Research, AstraZeneca, Gaithersburg, MD, USA, 2US Medical Affairs, AstraZeneca, Gaithersburg, MD, USA, 3Oncology Outcomes Research, AstraZeneca, Cambridge, United Kingdom, 4US Medical Affairs, AstraZeneca, New York, NY, USA, 5Global Oncology Data & Analytics, AstraZeneca, Gaithersburg, MD, USA, 6Global Medical Affairs, AstraZeneca, Cambridge, United Kingdom.
Presentation Documents
OBJECTIVES: Resectable GC/GEJC treatment patterns in the real-world are poorly described; this study describes treatments/outcomes for US patients.
METHODS: Data from patients diagnosed with ≥T2, N0-3, and M0, or T0-4, N1-3, and M0, GC/GEJC between January-01-2016 and October-31-2022 were retrospectively analyzed from the Flatiron Gastric database.
RESULTS: 901 GC and 816 GEJC patients were included, median age was 68.0 and 69.0 years, and 62.4% and 83.3% were male, respectively. Most patients had adenocarcinoma (GC: n=877 [97.3%]; GEJC: n=789 [96.7%]). Of 641 (71.1%) and 391 (47.9%) GC and GEJC patients receiving surgery, 100 (15.6%) and 274 (70.1%) received neoadjuvant treatment only, 169 (26.4%) and 22 (5.6%) adjuvant treatment only, 160 (25.0%) and 68 (17.4%) neoadjuvant+adjuvant treatment, and 212 (33.1%) and 27 (6.9%) no perioperative treatment, respectively. For GC patients, FLOT was the most common neoadjuvant treatment (neoadjuvant-only: n=43 [43.0%]; neoadjuvant+adjuvant: n=86 [53.8%]); the most common adjuvant treatments were FLOT (neoadjuvant+adjuvant: n=69 [43.1%]) and chemoradiotherapy (adjuvant-only: n=67 [39.6%]). Among GEJC patients, chemoradiotherapy was the most common neoadjuvant treatment (neoadjuvant-only: n=182 [66.4%]; neoadjuvant+adjuvant: n=46 [67.6%]); the most common adjuvant treatments were chemoradiotherapy (adjuvant-only: n=12 [54.5%]) and nivolumab (neoadjuvant+adjuvant: n=31 [45.6%]). Median (95% CI) event-free survival (EFS) for GC and GEJC patients, respectively, was 34.7 (27.5-42.3) and 22.0 (17.9-25.6) months for patients who received/had surgery planned, and 15.2 (13.0-18.6) and 21.0 (17.6-22.6) months for non-surgical patients; overall survival (OS) was 50.9 (43.7-62.4) and 38.6 (31.4-47.2) months for patients who received/had surgery planned, and 15.4 (13.1-18.6) and 21.0 (17.6-22.6) months for non-surgical patients.
CONCLUSIONS: Few patients received neoadjuvant+adjuvant treatment; over one-third of GC patients had not received any perioperative treatment. Among patients who had surgery/surgery planned, median EFS and OS were <3 and <5 years, with poorer outcomes for non-surgical patients, highlighting the need to optimize treatments to improve long-term outcomes.
METHODS: Data from patients diagnosed with ≥T2, N0-3, and M0, or T0-4, N1-3, and M0, GC/GEJC between January-01-2016 and October-31-2022 were retrospectively analyzed from the Flatiron Gastric database.
RESULTS: 901 GC and 816 GEJC patients were included, median age was 68.0 and 69.0 years, and 62.4% and 83.3% were male, respectively. Most patients had adenocarcinoma (GC: n=877 [97.3%]; GEJC: n=789 [96.7%]). Of 641 (71.1%) and 391 (47.9%) GC and GEJC patients receiving surgery, 100 (15.6%) and 274 (70.1%) received neoadjuvant treatment only, 169 (26.4%) and 22 (5.6%) adjuvant treatment only, 160 (25.0%) and 68 (17.4%) neoadjuvant+adjuvant treatment, and 212 (33.1%) and 27 (6.9%) no perioperative treatment, respectively. For GC patients, FLOT was the most common neoadjuvant treatment (neoadjuvant-only: n=43 [43.0%]; neoadjuvant+adjuvant: n=86 [53.8%]); the most common adjuvant treatments were FLOT (neoadjuvant+adjuvant: n=69 [43.1%]) and chemoradiotherapy (adjuvant-only: n=67 [39.6%]). Among GEJC patients, chemoradiotherapy was the most common neoadjuvant treatment (neoadjuvant-only: n=182 [66.4%]; neoadjuvant+adjuvant: n=46 [67.6%]); the most common adjuvant treatments were chemoradiotherapy (adjuvant-only: n=12 [54.5%]) and nivolumab (neoadjuvant+adjuvant: n=31 [45.6%]). Median (95% CI) event-free survival (EFS) for GC and GEJC patients, respectively, was 34.7 (27.5-42.3) and 22.0 (17.9-25.6) months for patients who received/had surgery planned, and 15.2 (13.0-18.6) and 21.0 (17.6-22.6) months for non-surgical patients; overall survival (OS) was 50.9 (43.7-62.4) and 38.6 (31.4-47.2) months for patients who received/had surgery planned, and 15.4 (13.1-18.6) and 21.0 (17.6-22.6) months for non-surgical patients.
CONCLUSIONS: Few patients received neoadjuvant+adjuvant treatment; over one-third of GC patients had not received any perioperative treatment. Among patients who had surgery/surgery planned, median EFS and OS were <3 and <5 years, with poorer outcomes for non-surgical patients, highlighting the need to optimize treatments to improve long-term outcomes.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD157
Topic
Real World Data & Information Systems
Disease
SDC: Gastrointestinal Disorders, SDC: Oncology