REAL-WORLD EPIDEMIOLOGY, TREATMENT PATTERNS, AND CLINICAL OUTCOMES OF METASTATIC COLORECTAL CANCER IN TAIWAN: A NATIONWIDE POPULATION-BASED STUDY, 2015-2021
Author(s)
Szu-Yu Chen, MS1, I-Tzu Chen, MS1, Ho-Min Chen, MS1, Hua Hsu, MS2, Kuo-Hsing Chen, PhD, MD3, Bor-Sheng Ko, PhD, MD4, Fei-Yuan Sharon Hsiao, PhD1.
1National Taiwan University, Taipei, Taiwan, 2Takeda Pharmaceuticals Taiwan, Ltd., Taipei, Taiwan, 3National Taiwan University Cancer Center, Taipei, Taiwan, 4National Taiwan University Hospital, New Taipei City, Taiwan.
1National Taiwan University, Taipei, Taiwan, 2Takeda Pharmaceuticals Taiwan, Ltd., Taipei, Taiwan, 3National Taiwan University Cancer Center, Taipei, Taiwan, 4National Taiwan University Hospital, New Taipei City, Taiwan.
OBJECTIVES: Metastatic colorectal cancer (mCRC) carries a high clinical and economic burden, yet most real-world evidence on mCRC treatment patterns and outcomes originates from Western populations. Robust mCRC data in Asian patients, who may differ in tumor biology, biomarker prevalence, and treatment response, remain scarce, particularly from single-payer universal healthcare systems. Using Taiwan's nationwide databases, we characterized CRC epidemiology and, among Asian patients with mCRC, described real-world treatment patterns, treatment duration, cross-line attrition, time to treatment failure (TTF), and overall survival (OS) to inform treatment sequencing and unmet need.
METHODS: This retrospective, population-based study linked Taiwan's National Health Insurance Research Database and Taiwan Cancer Registry Database, capturing an East Asian population under a near-universally covered, single-payer system. Incident CRC cases (2015-2021) were characterized for incidence and stage. Patients with mCRC initiating systemic therapy (2016-2021) were followed across lines of therapy. TTF and OS were estimated using Kaplan-Meier methods.
RESULTS: Among 103,498 incident CRC patients, age-standardized incidence declined from 60.10 to 53.48 per 100,000 person-years (2015-2021); 23.1% presented with Stage IV disease, with a median OS of 15.51 months and a 3-year survival of 23.31%. Of 18,613 mCRC patients receiving first-line chemotherapy, combined use of bevacizumab predominated (79.6% to75.7%), while anti-EGFR antibodies uptake rose from 20.4% to 24.4% (panitumumab 0.9% to 10.0%), reflecting growing biomarker-informed(RAS wild-type) selection. Attrition across lines was marked: 10,676, 7,949, and 3,820 patients reached 2L, 3L, and 4L therapy, respectively. Median TTF/OS shortened progressively from 1L to 4L(11.3/22.6, 6.2/12.7, 4.9/8.8, and 5.5/7.1 months), highlighting substantial unmet medical need in later lines.
CONCLUSIONS: This study provides real-world evidence on mCRC treatment and outcomes among Asian patients. Outcomes deteriorated across lines, with patient drop-off and poor later-line survival. Findings support biomarker-guided selection, optimized sequencing, and expanded later-line access for Asian mCRC patients, providing evidence to inform payers and policymakers in universal healthcare settings.
METHODS: This retrospective, population-based study linked Taiwan's National Health Insurance Research Database and Taiwan Cancer Registry Database, capturing an East Asian population under a near-universally covered, single-payer system. Incident CRC cases (2015-2021) were characterized for incidence and stage. Patients with mCRC initiating systemic therapy (2016-2021) were followed across lines of therapy. TTF and OS were estimated using Kaplan-Meier methods.
RESULTS: Among 103,498 incident CRC patients, age-standardized incidence declined from 60.10 to 53.48 per 100,000 person-years (2015-2021); 23.1% presented with Stage IV disease, with a median OS of 15.51 months and a 3-year survival of 23.31%. Of 18,613 mCRC patients receiving first-line chemotherapy, combined use of bevacizumab predominated (79.6% to75.7%), while anti-EGFR antibodies uptake rose from 20.4% to 24.4% (panitumumab 0.9% to 10.0%), reflecting growing biomarker-informed(RAS wild-type) selection. Attrition across lines was marked: 10,676, 7,949, and 3,820 patients reached 2L, 3L, and 4L therapy, respectively. Median TTF/OS shortened progressively from 1L to 4L(11.3/22.6, 6.2/12.7, 4.9/8.8, and 5.5/7.1 months), highlighting substantial unmet medical need in later lines.
CONCLUSIONS: This study provides real-world evidence on mCRC treatment and outcomes among Asian patients. Outcomes deteriorated across lines, with patient drop-off and poor later-line survival. Findings support biomarker-guided selection, optimized sequencing, and expanded later-line access for Asian mCRC patients, providing evidence to inform payers and policymakers in universal healthcare settings.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PT2
Topic
Clinical Outcomes, Epidemiology & Public Health, Real World Data & Information Systems
Disease
Gastrointestinal Disorders, Oncology