Background:
Colorectal cancer is the third most common cancer diagnosed in Australia. Although a large portion (46.4%) present at an early stage, up to 45% relapse and many others present with de novo metastatic disease.(1, 2) Although the treatment landscape for metastatic colorectal cancer (mCRC) is rapidly evolving, little is known about real-world impact of various regimens or utilisation rates of treatments beyond first-line.
Aims:
To evaluate the real-world rates of mCRC patients receiving systemic therapy beyond first line at a regional cancer centre (Sunshine Coast Hospital and Health Service - SCHHS). As well as the regimen choice and relative rates of treatment progression of the different regimens utilised in the first-line.
Methods:
A retrospective analysis of all patients with mCRC who received first-line palliative systemic chemotherapy between January 2014 and December 2020 at SCHHS has been conducted. Real-world treatment patterns including rates of progression and survival were also examined.
Results:
During this time period, 249 patients diagnosed with mCRC received first-line treatment at our center. Of these patients, 136 (54.6%) patients progressed to second-line treatment. Progression rates dropped through treatment lines, with 18.9% and 5.2% of patients receiving 3rdand 4thline treatments respectively. Doublet therapy with or without a biological agent was the most commonly used first line treatment option with 199 patients (79.9%).
Conclusion:
54.6% of mCRC patients at our center progressed onto second line treatment therapy, which is higher than the current literature with studies reporting rates of 48.9% and 52.2%. (3, 4)These results show that at our center, although percentages are lower than initially perceived, they are higher than other international statistics.