Chemotherapy treatment patterns in advanced colon cancer [poster]
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Background/Aims: Chemotherapy for Stage III/IV colon cancer incorporates new drugs, regimens, and broad treatment guidelines, thus allowing wide variation. Metastatic colon cancer cases at 7 HMO Research Network sites evaluated in the Comparative Effectiveness in Genomic and Personalized Medicine for Colon Cancer (CERGEN) study were evaluated for chemotherapy use by geography and patient characteristics.
Methods: Cases diagnosed between 1/1/04 and 12/31/09 were included and patient characteristics (comorbidities, treatment, KRAS status, and palliative care) were collected. KRAS testing was conducted on tumor specimens not previously tested. Analysis included descriptive statistics, incidence rates, and Cox proportional hazards regression models.
Results: Analysis of Stage III (n=422) and Stage IV (n=798) cases demonstrated the receipt of chemotherapy varied by stage (87%; 256 of 294 stage III and 68%; 630 of 926 stage IV, adjusted p-value=0.0452), geography (range 51-83%; adjusted p-value 0.0003; age (rate decreased with increasing age, adjusted p-value < 0.0001), Charlson Score (score 0, 76%; 147 of 196 to score 6+, 46%; 118 of 257; adjusted p-value < 0.0001), Medicare coverage (yes, 90%; 311 of 346 vs. no, 66%; 577 of 874; adjusted p-value < 0.0001), and positive family history of cancer (family history 82%; 460 of 561 vs. no family history 71%; 258 of 363; adjusted p-value < 0.0456). The median time to treatment varied by geography, stage, age, race, Medicare coverage, college education, household income, and other therapy.
Conclusions: Chemotherapy use and median time to treatment in advanced colon cancer varied by disease stage, geography, and patient characteristics.