Trifluridine/Tipiracil in the Real-World Management of Metastatic Gastric and Gastroesophageal Junction Cancers in Canada
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Population
2.2. Study Data
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Baseline Characteristic | n | Overall (n = 162) |
---|---|---|
Age at enrollment, y | 162 | 65 (58, 73) |
≤60 | 54 (33.3%) | |
61–70 | 52 (32.1%) | |
>70 | 56 (34.6%) | |
Geographic location | 162 | |
Ontario | 63 (38.9%) | |
Québec | 46 (28.4%) | |
British Columbia | 24 (14.8%) | |
Prairie provinces | 17 (10.5%) | |
Atlantic provinces | 12 (7.4%) | |
Primary disease site | 162 | |
Gastric | 126 (77.8%) | |
Gastroesophageal junction | 36 (22.2%) | |
HER2 status | 64 | |
Negative | 52 (81.2%) | |
Positive | 12 (18.8%) | |
Prior lines of therapy (denominator = 162 for each) | 162 | |
FOLFIRI | 22 (13.6%) | |
FOLFOX | 22 (13.6%) | |
Paclitaxel | 22 (13.6%) | |
Ramucirumab | 17 (10.5%) | |
5-FU/LV | 6 (3.7%) | |
Capecitabine | 6 (3.7%) | |
Cisplatin | 6 (3.7%) | |
Trastuzumab | 5 (3.1%) | |
CAPOX | 4 (2.5%) | |
Irinotecan | 4 (2.5%) | |
Platinum | 3 (1.9%) | |
Taxane | 3 (1.9%) | |
Fluoropyrimidine | 2 (1.2%) | |
Docetaxel | 1 (0.6%) | |
Regorafenib | 1 (0.6%) | |
Other | 130 (80.2%) | |
Naive | 4 (2.5%) |
Trifluridine/Tipiracil Treatment Characteristic | n | Overall (n = 162) |
---|---|---|
Treatment status | 162 | |
Discontinued | 121 (74.7%) | |
Never received | 38 (23.5%) | |
Currently receiving | 2 (1.2%) | |
Pending | 1 (0.6%) | |
Reason for never having started treatment | 39 | |
Death | 10 (25.6%) | |
Physician decision | 9 (23.1%) | |
Consent withdrawal | 5 (12.8%) | |
Pending | 1 (2.6%) | |
Other | 14 (35.9%) | |
Reason for treatment discontinuation | 121 | |
Disease progression | 63 (52.1%) | |
Death | 25 (20.7%) | |
Physician decision | 13 (10.7%) | |
Adverse event | 5 (4.1%) | |
Other | 15 (12.4%) | |
Health Canada Special Access Program enrollment | 162 | |
No | 156 (96.3%) | |
Yes | 6 (3.7%) | |
Reimbursement type | 157 | |
Compassionate | 69 (43.9%) | |
Private | 37 (23.6%) | |
Bridging | 32 (20.4%) | |
Public | 18 (11.5%) | |
Cash Paying | 1 (0.6%) | |
Time from enrollment to therapy start, days | 123 | 7 (5, 13) |
Therapy duration, cycles | 121 | 2.39 (1.14, 3.86) |
Last treatment cycle completed | ||
<1 | 26 (21.5%) | |
1 | 19 (15.7%) | |
2 | 22 (18.2%) | |
3 | 24 (19.8%) | |
≥4 | 30 (24.8%) | |
Body surface area, m2 | 146 | 1.77 (1.66, 1.95) |
First planned trifluridine/tipiracil dose, mg | 128 | 60 (55, 65) |
Treatment modification | 123 | |
Dose maintained | 90 (73.2%) | |
Dose delay | 11 (8.9%) | |
Dose reduction | 7 (5.7%) | |
Dose reduction and delay | 15 (12.2%) |
Characteristic | n | Overall (n = 121) | Last Treatment Cycle Completed | p Value | |
---|---|---|---|---|---|
<2 (n = 45) | ≥2 (n = 76) | ||||
Age at enrollment, y | 121 | 65 (58, 72) | 65 (55, 72) | 64 (59, 73) | 0.34 |
≤60 | 41 (33.9%) | 16 (35.6%) | 25 (32.9%) | 0.95 | |
61–70 | 39 (32.2%) | 14 (31.1%) | 25 (32.9%) | ||
>70 | 41 (33.9%) | 15 (33.3%) | 26 (34.2%) | ||
Geographic location | 121 | 0.44 | |||
Ontario | 44 (36.4%) | 16 (35.6%) | 28 (36.8%) | ||
Québec | 39 (32.2%) | 15 (33.3%) | 24 (31.6%) | ||
British Columbia | 15 (12.4%) | 5 (11.1%) | 10 (13.2%) | ||
Prairie provinces | 15 (12.4%) | 8 (17.8%) | 7 (9.2%) | ||
Atlantic provinces | 8 (6.6%) | 1 (2.2%) | 7 (9.2%) | ||
Primary disease site | 121 | 0.29 | |||
Gastric | 96 (79.3%) | 38 (84.4%) | 58 (76.3%) | ||
Gastroesophageal junction | 25 (20.7%) | 7 (15.6%) | 18 (23.7%) | ||
HER2 status | 48 | 0.43 | |||
Negative | 40 (83.3%) | 13 (76.5%) | 27 (87.1%) | ||
Positive | 8 (16.7%) | 4 (23.5%) | 4 (12.9%) | ||
Reason for treatment discontinuation | 121 | 0.04 | |||
Disease progression | 63 (52.1%) | 18 (40.0%) | 45 (59.2%) | ||
Death | 25 (20.7%) | 12 (26.7%) | 13 (17.1%) | ||
Physician decision | 13 (10.7%) | 3 (6.7%) | 10 (13.2%) | ||
Adverse event | 5 (4.1%) | 4 (8.9%) | 1 (1.3%) | ||
Other | 15 (12.4%) | 8 (17.8%) | 7 (9.2%) | ||
Health Canada Special Access Program enrollment | 121 | 0.56 | |||
No | 118 (97.5%) | 43 (95.6%) | 75 (98.7%) | ||
Yes | 3 (2.5%) | 2 (4.4%) | 1 (1.3%) | ||
Reimbursement type | 121 | 0.76 | |||
Compassionate | 51 (42.1%) | 20 (44.4%) | 31 (40.8%) | ||
Private | 27 (22.3%) | 9 (20.0%) | 18 (23.7%) | ||
Bridging * | 27 (22.3%) | 9 (20.0%) | 18 (23.7%) | ||
Public | 15 (12.4%) | 6 (13.3%) | 9 (11.8%) | ||
Cash Paying | 1 (0.8%) | 1 (2.2%) | 0 (0.0%) | ||
Time from enrollment to therapy start, days | 121 | 7 (5, 13) | 7 (5, 14) | 7 (5, 12) | 0.89 |
Body surface area, m2 | 113 | 1.78 (1.66, 1.96) | 1.74 (1.65, 1.90) | 1.81 (1.69, 1.99) | 0.10 |
First planned trifluridine/tipiracil dose, mg | 104 | 60 (55, 65) | 60 (55, 65) | 60 (55, 65) | 0.91 |
Factor | Odds Ratio (95% Confidence Interval) | p Value |
---|---|---|
Age at enrollment, y | 0.81 | |
≤60 | Reference | |
61–70 | 1.36 (0.52, 3.62) | |
>70 | 1.08 (0.41, 2.84) | |
Geographic location | 0.27 | |
Ontario | Reference | |
Québec | 0.89 (0.36, 2.24) | |
British Columbia | 1.02 (0.29, 3.89) | |
Prairie provinces | 0.41 (0.11, 1.44) | |
Atlantic provinces | 4.48 (0.67, 89.77) | |
Primary disease site | 0.20 | |
Gastric | Reference | |
Gastroesophageal junction | 1.97 (0.71, 6.05) | |
Prior FOLFIRI | 0.33 | |
No | Reference | |
Yes | 1.89 (0.53, 7.88) | |
Prior FOLFOX | 0.30 | |
No | Reference | |
Yes | 0.47 (0.10, 1.96) | |
Prior paclitaxel | 0.76 | |
No | Reference | |
Yes | 1.37 (0.19, 12.28) | |
Prior ramucirumab | 0.78 | |
No | Reference | |
Yes | 0.74 (0.08, 5.93) |
Factor | Odds Ratio (95% Confidence Interval) | p Value |
---|---|---|
Age at enrollment, y | 0.41 | |
≤60 | Reference | |
61–70 | 0.91 (0.36, 2.31) | |
>70 | 1.67 (0.65, 4.40) | |
Geographic location | 0.16 | |
Ontario | Reference | |
Québec | 1.45 (0.59, 3.64) | |
British Columbia | 1.13 (0.34, 3.89) | |
Prairie provinces | 0.93 (0.27, 3.22) | |
Atlantic provinces | 0.13 (0.01, 0.89) | |
Primary disease site | 0.53 | |
Gastric | Reference | |
Gastroesophageal junction | 1.38 (0.51, 3.83) | |
Prior FOLFIRI | 0.82 | |
No | Reference | |
Yes | 0.86 (0.24, 3.02) | |
Prior FOLFOX | 0.22 | |
No | Reference | |
Yes | 2.44 (0.60, 11.54) | |
Prior paclitaxel | 0.50 | |
No | Reference | |
Yes | 0.52 (0.07, 3.60) | |
Prior ramucirumab | 0.45 | |
No | Reference | |
Yes | 2.16 (0.28, 17.79) |
Factor | Odds Ratio (95% Confidence Interval) | p Value |
---|---|---|
Age at enrollment, y | 0.97 | |
≤60 | Reference | |
61–70 | 1.15 (0.40, 3.38) | |
>70 | 1.06 (0.36, 3.17) | |
Geographic location | 0.71 | |
Ontario | Reference | |
Québec | 1.53 (0.57, 4.21) | |
British Columbia | 1.05 (0.23, 4.16) | |
Prairie provinces | 0.69 (0.12, 2.95) | |
Atlantic provinces | 0.46 (0.02, 3.34) | |
Primary disease site | 0.86 | |
Gastric | Reference | |
Gastroesophageal junction | 1.10 (0.35, 3.16) | |
Prior FOLFIRI | 0.02 | |
No | Reference | |
Yes | 4.42 (1.26, 17.06) | |
Prior FOLFOX | 0.69 | |
No | Reference | |
Yes | 0.74 (0.15, 3.15) | |
Prior paclitaxel | 0.79 | |
No | Reference | |
Yes | 1.31 (0.16, 10.43) | |
Prior ramucirumab | 0.93 | |
No | Reference | |
Yes | 0.91 (0.09, 8.00) |
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Share and Cite
Ding, P.Q.; Dolley, A.; Cheung, W.Y. Trifluridine/Tipiracil in the Real-World Management of Metastatic Gastric and Gastroesophageal Junction Cancers in Canada. Curr. Oncol. 2023, 30, 130-144. https://doi.org/10.3390/curroncol30010011
Ding PQ, Dolley A, Cheung WY. Trifluridine/Tipiracil in the Real-World Management of Metastatic Gastric and Gastroesophageal Junction Cancers in Canada. Current Oncology. 2023; 30(1):130-144. https://doi.org/10.3390/curroncol30010011
Chicago/Turabian StyleDing, Philip Q., Aastha Dolley, and Winson Y. Cheung. 2023. "Trifluridine/Tipiracil in the Real-World Management of Metastatic Gastric and Gastroesophageal Junction Cancers in Canada" Current Oncology 30, no. 1: 130-144. https://doi.org/10.3390/curroncol30010011
APA StyleDing, P. Q., Dolley, A., & Cheung, W. Y. (2023). Trifluridine/Tipiracil in the Real-World Management of Metastatic Gastric and Gastroesophageal Junction Cancers in Canada. Current Oncology, 30(1), 130-144. https://doi.org/10.3390/curroncol30010011