Unmet Needs in Late-Line Metastatic Colorectal Cancer in Portugal: An Expert-Informed Epidemiological Forecast
Author(s)
Pedro Labisa, MSc1, Joana Sousa, MSc2, Pedro Cardoso, MSC2, Tomás Oliveira, MSc2.
1Takeda Oncology, Lisbon, Portugal, 2MOAI Consulting, Lisbon, Portugal.
1Takeda Oncology, Lisbon, Portugal, 2MOAI Consulting, Lisbon, Portugal.
Presentation Documents
OBJECTIVES: Epidemiological data for metastatic colorectal cancer (mCRC) in Portugal are limited. Currently, for patients in Portugal with late-line (3L+) mCRC, trifluridine/tipiracil (FTD/TPI) is the only reimbursed option. This study aims to quantify the number of individuals with late-line mCRC in Portugal without access to approved therapies.
METHODS: Five Portuguese oncologists experienced in managing mCRC provided clinical insights on stage at diagnosis, progression, treatment patterns, and unmet needs in late-line settings (3L+). Inputs were collected via structured elicitation using the Sheffield Elicitation Framework (SHELF) through a questionnaire with open numerical questions; data were analyzed to extract medians and confidence intervals. These informed baseline probabilities were applied to national CRC incidence data from GLOBOCAN 2022 to develop an Excel-based tabular model estimating patient distribution across disease stages and treatment lines, incorporating time-dependent progression and user-defined inputs.
RESULTS: The experts estimate that approximately 33% (range:19-57, SD 16.7) of patients are diagnosed with metastatic disease, and 19% (range:15-22, SD 2.9) recur after a median of 16 months. According to estimations, in Portugal, 10,843 new CRC cases are expected to be diagnosed in 2025, resulting in a predicted 4900 active metastatic patients in 2025 and 5193 by 2030. Of these patients, 60% (range:50-75, SD 10.3) are expected to be eligible for systemic treatment in 3L, and 30% in 4L+ (range:7-55, SD 12.4). Approximately 60% (range:20-88, SD 9.2) of patients are treated with FTD/TPI in 3L, but 5% are considered intolerant to FTD/TPI. In 2025, an estimated 624 mCRC patients will lack therapeutic options across 3L and 4L+, totaling 3,231 patients over the next five years.
CONCLUSIONS: A substantial unmet need exists in 3L+ mCRC treatment in Portugal, with limited therapeutic options available. The number of patients lacking access to effective treatment is expected to increase by 2030, underscoring the need of reimbursement for innovative therapeutic strategies.
METHODS: Five Portuguese oncologists experienced in managing mCRC provided clinical insights on stage at diagnosis, progression, treatment patterns, and unmet needs in late-line settings (3L+). Inputs were collected via structured elicitation using the Sheffield Elicitation Framework (SHELF) through a questionnaire with open numerical questions; data were analyzed to extract medians and confidence intervals. These informed baseline probabilities were applied to national CRC incidence data from GLOBOCAN 2022 to develop an Excel-based tabular model estimating patient distribution across disease stages and treatment lines, incorporating time-dependent progression and user-defined inputs.
RESULTS: The experts estimate that approximately 33% (range:19-57, SD 16.7) of patients are diagnosed with metastatic disease, and 19% (range:15-22, SD 2.9) recur after a median of 16 months. According to estimations, in Portugal, 10,843 new CRC cases are expected to be diagnosed in 2025, resulting in a predicted 4900 active metastatic patients in 2025 and 5193 by 2030. Of these patients, 60% (range:50-75, SD 10.3) are expected to be eligible for systemic treatment in 3L, and 30% in 4L+ (range:7-55, SD 12.4). Approximately 60% (range:20-88, SD 9.2) of patients are treated with FTD/TPI in 3L, but 5% are considered intolerant to FTD/TPI. In 2025, an estimated 624 mCRC patients will lack therapeutic options across 3L and 4L+, totaling 3,231 patients over the next five years.
CONCLUSIONS: A substantial unmet need exists in 3L+ mCRC treatment in Portugal, with limited therapeutic options available. The number of patients lacking access to effective treatment is expected to increase by 2030, underscoring the need of reimbursement for innovative therapeutic strategies.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH271
Topic
Epidemiology & Public Health, Health Policy & Regulatory, Health Technology Assessment
Disease
Oncology