Treatment patterns and outcomes in advanced or metastatic gastric/gastroesophageal junction adenocarcinoma in China

Describe the characteristics, treatment patterns and outcomes of Chinese patients with unresectable advanced/metastatic (UAM) gastric/gastroesophageal junction adenocarcinoma (GA/GEJA). This multicenter, retrospective, observational study included adults diagnosed with UAM GA/GEJA in China from 2017–2020. Among 2,745 patients, 1,902, 729, and 284 received first-, second- and third-line (1 L, 2 L and 3 L) therapy–respectively. Most patients received chemotherapy alone in 1 L (84.1%) and 2 L (63.6%), and targeted-therapy–based treatment in 3 L (49.2%). Median real-world progression-free survival (rwPFS) was 6.5, 4.2, and 3.2 months in 1 L, 2 L, and 3 L, respectively. Chinese patients with UAM GA/GEJA mainly received chemotherapy alone in 1 L/2 L and targeted therapy in 3 L. Median rwPFS was short in all lines, highlighting the need for more effective treatments. Gastric (stomach) cancer is one of the leading causes of cancer-related death globally, and nearly four-in-ten of those cases and deaths occur in China. Despite this high disease burden, real-world data on clinical outcomes and which treatments are used are lacking from Chinese patients with gastric cancer. Therefore, we examined patient records from four large hospitals in China between 2017 and 2020, selecting adults diagnosed with gastric cancer (or a type of cancer between the stomach and esophagus), whose disease was advanced-stage or had spread. We analyzed data on the time until patients’ tumors grew or spread (disease progression), the patient had to switch therapies because of disease progression, or the patient died (together called real-world progression-free survival, or rwPFS). We also tracked which treatments the patients were using and when this changed. From the large number of patients (2,745), we found that the treatment patterns generally reflected established guidelines at the time, with the majority of initial treatments used either first or second being based on chemotherapy. We found that the median rwPFS was short, decreasing from 6.5 months, to 4.2 months, then 3.2 months each time the therapy needed to be changed. These findings provide important real-world data that improve our understanding of current treatments and real-world outcomes in Chinese patients with this type of cancer. Our results also highlight a need for more effective and novel treatment options, with the ultimate goal of improving treatment outcomes.