Third-line treatment patterns and clinical outcomes for metastatic colorectal cancer: a retrospective real-world study

BACKGROUND: There are multiple recommendations on the third-line therapy of metastatic colorectal cancer (mCRC); however, no consensus has been reached. OBJECTIVES: This study aimed to explore the patient demographics and the real-world third-line treatment landscape of mCRC. DESIGN: A retrospective...

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Detalles Bibliográficos
Autores principales: Deng, Ting, Duan, Jingjing, Bai, Ming, Zhang, Le, Li, Hongli, Liu, Rui, Ning, Tao, Ge, Shaohua, Wang, Xia, Yang, Yuchong, Ji, Zhi, Wang, Feixue, Ba, Yi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Original Research
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501067/
https://www.ncbi.nlm.nih.gov/pubmed/37720594
http://dx.doi.org/10.1177/20406223231197311
Descripción
Sumario:BACKGROUND: There are multiple recommendations on the third-line therapy of metastatic colorectal cancer (mCRC); however, no consensus has been reached. OBJECTIVES: This study aimed to explore the patient demographics and the real-world third-line treatment landscape of mCRC. DESIGN: A retrospective real-world cohort study. METHODS: Electronic medical records of mCRC patients from Tianjin Medical University Cancer Institute and Hospital between 2013 and 2020 were collected. Upon descriptive, comparative, and survival analyses, a retrospective study was conducted to describe demographics and clinical outcomes of mCRC patients receiving third-line treatment. RESULTS: Among 218 mCRC patients receiving third-line therapy, 65.5% received chemotherapy combined with or without targeted drugs, followed by anti-angiogenic monotherapy (18.4%), anti-epidermal growth factor receptor drugs (6.9%) and immunotherapy (6.4%). The overall response rate and disease control rate reached 10.2% and 59.2%, respectively; and median progression-free survival (PFS) and overall survival were 4.0 m and 10.7 m, respectively. After Cox multivariate analysis, we found that therapeutic regime was an independent prognostic factor. Compared to patients receiving anti-angiogenic monotherapy, those receiving chemotherapy combined with or without targeted drugs exhibited better prognosis. For patients whose PFS were longer in the front-line treatment, the PFS of third-line therapy was also relatively longer (p = 0.023). Multiple types of therapies (>3, p = 0.002) or multiple drugs (>5, p = 0.024) in the whole-course management of mCRC are indicators of longer survival. CONCLUSION: Chemotherapy combined with or without targeted therapy remained dominated third-line choice and showed favorable efficacy compared with anti-angiogenic monotherapy. With the application of more types and quantities of effective drugs, patients would achieve better survival.

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