Real-world database analysis of the characteristics and treatment patterns of patients with endometrial cancer in Japan

Abstract

Objective

The aim was to identify the characteristics and treatment patterns of early and advanced stage endometrial cancer patients using real-world data.

Methods

Patients’ data extracted from a Japanese health insurance claims database were analyzed.

Results

Of the 12,449 endometrial cancer patients, 74.4% were in stage I, 5.1% in stage II, 12.0% in stage III, and 8.4% in stage IV. Their median age was 60.5 years, higher in advanced stages (III/IV) than in early stages (I/II). Overall, 11,055 patients (88.8%) underwent surgery, and 4977 patients (40.0%) received post-surgery treatment, including chemotherapy (4441: 35.7%), chemoradiation therapy (379: 3.0%), and radiation therapy (157 patients: 1.3%); 1394 patients (11.2%) were not treated by surgery, and 742 patients (6.0%) received other treatment, with chemotherapy (548: 4.4%), radiation therapy (105: 0.8%), and chemoradiation therapy (89: 0.7%). The rate of patients undergoing surgery decreased, and that receiving chemotherapy increased significantly as cancer stage progressed. Paclitaxel/carboplatin was the most frequent first-line regimen (85.4% of patients), whereas various combination and monotherapy regimens were used as second- and third-line regimens. The most frequent second-line monotherapy was paclitaxel. The rate of monotherapy increased as the treatment line progressed (first-line 3.5%, second-line 22.0%, and third-line 36.4%).

Conclusions

The characteristics and treatment patterns of endometrial cancer patients differed between early and advanced stages, as did the chemotherapy regimens among first-, second-, and third-lines. Since various regimens were used for second- and third-line chemotherapies, development of appropriate second- and third-line chemotherapy regimens is warranted. A real-world analysis of cancer patients using a nationwide claims database may be a valuable approach to identifying unmet medical needs.

Keywords:

• Endometrial cancer
• database analysis
• surgery
• chemotherapy
• radiation

Transparency

Declaration of funding

This work was supported by Eisai Co., Ltd, which provided funding for the collection, analysis, and interpretation of data, and was involved in the writing of the report and the decision to submit the paper for publication

Declaration of financial/other relationships

KAk, NK, TM, EF, YM, and KAo report personal fees from Eisai Co. Ltd. during the conduct of the study and personal fees from Eisai Co. Ltd. outside the submitted work. KF reports grants from Astra Zeneca, Pfizer, MSD, Taiho, Zeria, Chugai, GSK, Lilly, Immunogen, Oncotherapy, Regeneron, and Genmab outside the submitted work. Peer reviewers on this manuscript have received an honorarium from CMRO for their review work but have no other relevant financial relationships to disclose.

Author contributions

All of the authors take responsibility for the analysis and interpretation of the data.

NK, TM, and EF were responsible for Conceptualization, Funding acquisition, Investigation and Writing - original draft. KAk, YM, and KAo were responsible for the Methodology, Formal analysis, Data curation, Investigation and Writing - review & editing.

KF was responsible for Supervision, Investigation and Writing - review & editing.

Acknowledgements

The authors thank FORTE Science Communications (Tokyo, Japan) for writing and editorial support.

Data availability statement

All data disclosed in this manuscript were generated from the Japanese health insurance claims database provided by Medical Data Vision Co., Ltd. (MDV; Tokyo, Japan). All information referred to the manuscript text is disclosed in the figures, tables and supplementary tables provided.