美国晚期或复发子宫内膜癌患者开始一线治疗的治疗模式和结果

Robert Coleman, Jamie Garside, Jean Hurteau, Joehl Nguyen, Monica Kobayashi
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引用次数: 0

摘要

背景:晚期或复发子宫内膜癌(EC)患者通常有有限的治疗选择和较差的一线治疗后的长期生存结果。在这种情况下,真实世界的治疗模式和生存结果数据是有限的。目的:这项回顾性研究的目的是描述美国原发性晚期或复发性EC患者的真实世界人口统计学、临床特征、治疗模式和总生存率,这些患者至少接受了1线治疗(LOT)。方法:纳入2013年1月1日至2021年7月31日真实世界数据库中诊断为原发性晚期或复发性EC的患者。纳入日期为EC诊断文件的日期;在第一次LOT开始时以及在他们开始的每个后续LOT开始时,对患者的治疗模式和结果进行索引。数据按错配修复缺陷(dMMR)或微卫星不稳定性高(MSI-H)肿瘤患者亚组分层。结果:共纳入1961例至少接受1次LOT治疗的患者。该队列中的大多数患者,以及dMMR/MSI-H亚组,接受铂联合治疗作为一线治疗,卡铂-紫杉醇是最常见的方案。在接受一线治疗的患者中,只有53%的患者随后接受了二线治疗。在接受至少1次LOT治疗的患者中,二线免疫治疗在dMMR/MSI-H亚组中更为常见。在≥1次LOT队列中,5种最常用的一线治疗方案的中位总生存期为14.1至31.8个月,并且随着每次LOT的增加而缩短。讨论:在现实世界中,尽管大多数方案的长期生存结果较差,但在晚期或复发性EC的一线治疗中,以铂类化疗为主。结论:复发/晚期EC患者预后较差,强调需要更持久的治疗。
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Treatment Patterns and Outcomes Among Patients With Advanced or Recurrent Endometrial Cancer Initiating First-Line Therapy in the United States
Background: Patients with advanced or recurrent endometrial cancer (EC) typically have limited treatment options and poor long-term survival outcomes following first-line therapy. Real-world treatment patterns and survival outcomes data are limited for patients in this setting. Objectives: The objective of this retrospective study was to describe real-world demographics, clinical characteristics, treatment patterns, and overall survival among patients in the United States with primary advanced or recurrent EC who initiated at least 1 line of therapy (LOT). Methods: Patients with a diagnosis of primary advanced or recurrent EC in a real-world database from January 1, 2013, to July 31, 2021, were included. The date for inclusion was the date of EC diagnosis documentation; patients were indexed for treatment patterns and outcomes at the start of the first LOT and at the start of each subsequent LOT they initiated. Data were stratified by subgroups of patients who had mismatch repair deficient (dMMR) or microsatellite instability-high (MSI-H) tumors. Results: A total of 1961 patients who received at least 1 LOT were included. Most patients in this cohort, and the dMMR/MSI-H subgroup, received a platinum combination as first-line treatment, with carboplatin-paclitaxel being the most common regimen. Only 53% of patients who received first-line treatment subsequently received second-line therapy. Of the patients who received at least 1 LOT, use of immunotherapy in the second-line setting was more common in the dMMR/MSI-H subgroup. Median overall survival ranged from 14.1 to 31.8 months across the 5 most frequently used first-line treatment regimens in the ≥1 LOT cohort and became shorter with each subsequent LOT. Discussion: The use of platinum-based chemotherapy for first-line treatment of advanced or recurrent EC predominates in the real-world setting, despite the poor long-term survival outcomes associated with most of these regimens. Conclusions: Patients with recurrent/advanced EC have a poor prognosis, highlighting the need for therapies with more durable benefits.
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发文量
55
审稿时长
10 weeks
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