OBJECTIVES

Esophageal cancer is the 7th most common cancer in Spain, with an incidence of 2,383 cases per year. Patient with EC has significant unmet medical need, poor quality of life and low survival rates.

METHODS

A retrospective, non-interventional survey of 52 Spanish physicians was conducted between August-November 2018. Clinical data were collected from medical charts for patients aged ≥20 years who had initiated through completion or stopping 1/2 line treatment for ESCC and for esophageal adenocarcinoma or BSC at either line of therapy. Excluded were patients with adenosquamous carcinoma, or with Siewert type 1 gastroesophageal junction cancer .

RESULTS

The 52 physicians surveyed were aged 46.5±11.44y , 71.2% male, 14.9±5.9y in practice, 93.4% hospital-based, and treated a median of 50 EC patients in the past 2 years.

149 patients were included, with mean age at 1L of 62.8±9.2y and 83.5% male. At diagnosis patients presented the following comorbidities: 28.9% hypertension, 27.5% hyperlipidemia, 23.5% diabetes, 14.8% dysphagia, and 14.1% chronic obstructive pulmonary disease.

At 1L, 91.1% of EC patients received active systemic therapy (Cisplatin+5-FU=19.0%) and 8.1% received BSC (ESCC=5.1%; EAC=11.4%). In 2L (n=44), 81.8% (n=36) of EC patients received systemic treatment (docetaxel n=9; 25.0%) and 18.2% (n=8) received BSC (20.0% in EAC vs 16.7% in ESCC). Physician-reported treatment decisions based primarily on personal experience (35%) and side effects (65%). The main 2L treatment goals were extent patients' life (41.7%) and relieve symptoms (29.2%). For 2L ESCC patients, the most common grade 3 or 4 adverse events were fatigue (70%), neutropenia (55%) and anemia (50%).

CONCLUSIONS

In this real-world survey of Spanish physicians, approximately 1/20 ESCC patients received BSC at 1L, whereas approximately 1/6 ESCC patients received BSC at 2L. Data indicated that physician treatment decision-making, treatment goals, and adverse events show a great unmet need for a more efficacious or a safer/better tolerated 2L ESCC treatment.