Real-world treatment patterns among patients with advanced gastric cancer in Russia: a chart review study

Abstract

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

Methods: Eligible patients were ≥18 years old, diagnosed with mGC ≥ January 1, 2012, received first-line chemotherapy followed by second-line chemotherapy or best supportive care (BSC), had ≥3 months of follow-up after the start of second-line chemotherapy or BSC (except in cases of death), and had not participated in a clinical trial. Data were summarized using descriptive statistics.

Results: A total of 88 physicians provided data from 202 charts. Mean age at mGC diagnosis was 53.7 (standard deviation: 11.2) years; 70.8% of patients were male. Reasons for first-line treatment discontinuation included disease progression (50.5%) and adverse events/toxicity (39.1%). There were 52 unique treatment regimens prescribed in second-line; capecitabine (14.5%), paclitaxel (9.3%), and capecitabine + oxaliplatin (8.7%) were the most frequent. Reasons for second-line treatment discontinuation included disease progression (39.8%) and patient refusal to continue (37.5%). During 2nd-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 most frequently used as supportive care.

Conclusions: Second-line treatment patterns for patients with mGC in Russia are heterogeneous. Results of this study indicate the need for more intensive implementation of the most active regimens in second-line treatment of mGC according to international and national guidelines.

Keywords:

• (MeSH): gastrointestinal neoplasms
• stomach neoplasms
• Russia
• drug therapy
• palliative care

Transparency

Declaration of funding

This study was funded by Eli Lilly and Company.

Declaration of financial/other relationships

ES and DN are employees of Eli Lilly and Company and may own stock/stock options. WYC and PT-L are employees of Analysis Group Inc., which has received research funding from Eli Lilly and Company to conduct analyses for the current study. JII and LMS were employees of Analysis Group, Inc. at the time of the study. JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors contributed to the study design, interpretation of the results, and manuscript development. LMS and PT-L performed data analysis. All authors agreed to submit the manuscript for publication.

Acknowledgements

The authors would like to thank Sara Kaffashian for editorial assistance.

Prior presentations

Parts of the material in this manuscript have been presented as a poster at the International Society for Pharmacoeconomics and Outcomes Research 20th Annual European Congress (Glasgow, Scotland 2017).