Introduction/Background Growing interest in the use of novel therapies in earlier setting is changing the treatment approach in patients with recurrent or advanced endometrial cancer (aEC). However, real-world treatment patterns and outcomes for existing 1st-line treatment are not well understood in Europe.
Methodology Endometrial Cancer Health Outcomes-Europe-1st-Line (ECHO-EU-1L) is a multicenter, retrospective, chart review study in patients diagnosed with recurrent or aEC across the United Kingdom (UK), France, Germany, Italy, and Spain. Physicians extracted data from medical records of adult female patients diagnosed with recurrent or aEC (Stage III or IV) initiating 1st-line systemic therapy between July 1, 2016 – March 31, 2020. Data included patient demographics, clinical/treatment characteristics, and clinical outcomes. Data were de-identified before conducting analyses. Kaplan-Meier analyses were performed to estimate time-to-treatment discontinuation, real-world progression-free survival (rwPFS) and overall survival (OS). The study was IRB-approved in respective countries.
Results At 1st-line initiation, median age of 244 eligible patients was 69 years, 49.6% had endometroid carcinoma histology, and 76.7% had an ECOG status of 0/1. For 1st-line therapy, 227 (93%) received chemotherapy-based regimen (carboplatin plus paclitaxel (CP)most common), while 7% received hormonal or other therapy. After a median of 3 months on 1st-line therapy, 163 (66.8%) patients reached an overall response; 70 (43%) eventually lost response. During the 19-month median follow-up, 233 (96%) discontinued after a median of 5 months. Median OS from 1st-line initiation was 21 months (95% CI:18.0–23.0) and median rwPFS was 12 months (95% CI:11.0–14.0).
Conclusion In Europe, CP is the standard 1st treatment for recurrent or aEC patients. A third of patients do not respond to CP therapy; patients had poor outcomes with median survival <2 years and median PFS of 1 year. Overall, there seems to be significant unmet medical need and novel therapies could improve outcomes in this patient population.
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