OBJECTIVES: Little evidence is available on the management of patients with metastatic and/or unresectable gastric cancer (mGC) after failure of 1^st-line treatment. This study presents real-world data on patient characteristics and treatment patterns for these patients in Russia.

METHODS: Eligible patients were ≥18 years old, diagnosed with mGC on or after January 1, 2012, had received 1^st-line chemotherapy including platinum analogue/fluoropyrimidine followed by 2^nd-line chemotherapy or best supportive care (BSC), had ≥3 months of follow-up after the start of 2^nd-line chemotherapy or BSC (except in cases of death), and had not participated in a clinical trial. Data were obtained from the patients’ charts, and summarized using descriptive statistics.

RESULTS: Data from 202 charts were collected. Mean age was 53.7 (standard deviation [SD]: 11.2) years. 70.8% of patients were male. ECOG performance status (PS) at the start of 1^st-line therapy was 15.5% PS=0, 58.3% PS=1, 16.7% PS=2, 8.9% PS=3. Reasons for 1^st-line treatment discontinuation included disease progression (50.5%) and adverse events/toxicity (39.1%). There were 52 unique treatment regimens prescribed in 2^nd-line; capecitabine (14.5%), paclitaxel (9.3%), and capecitabine+oxaliplatin (8.7%) were the most frequent. Reasons for 2^nd-line treatment discontinuation included disease progression (39.8%) and patient refusal to continue (37.5%). During 2^nd-line treatment, the most common treatment-related symptoms were nausea/vomiting (75.0%), while pain (73.8 %) was the most common disease-related symptom. Antiemetics (63.4%), chemotherapy (61.6%), non-narcotic analgesics (48.3%), endoscopy (45.9%), and nutritional support (35.5%) were used as supportive care. Most patients were hospitalized at least once during 2^nd-line treatment for drug administration (74.5%) or other cancer-related care (24.4%).

CONCLUSIONS: Second-line treatment patterns for patients with mGC in Russia are highly heterogeneous. The results of this study indicate the need for more intensive implementation of the most active regimens in 2^nd-line treatment of mGC according to international and national guidelines.