Long-term management and outcomes in gastroesophageal cancer in Norway

BackgroundGastroesophageal cancer is the fifth most common cancer worldwide and a leading cause of cancer mortality. There is limited real-world evidence (RWE) for the management of patients with gastroesophageal cancer in Norway; specifically, outcomes in patients treated with neoadjuvant chemotherapy versus chemoradiation. This study aimed to report patient demographics, treatment patterns, and overall survival (OS).MethodsThis was a retrospective study of patients with esophageal squamous cell cancer (ESCC), esophageal adenocarcinoma (EAC), gastroesophageal junction cancer (GEJC), and gastric cancer (GC). Data were collected from the Cancer Registry of Norway. The cohort included patients who received initial palliative or curative treatment within 1 year of diagnosis (2010–21). Curative treatments were defined as neoadjuvant systemic anti-cancer therapy (SACT) plus radiotherapy (RT) (any dose) followed by surgery (SACT + RT/surgery), definitive SACT plus RT (≥40Gy) (SACT + RT), SACT followed by surgery (any treatment following surgery allowed) (SACT/surgery), and primary surgery. Palliative treatments were defined as RT (<40Gy) and/or SACT without surgery, or no registered treatment.ResultsThe cohort included 8,204 patients (curative n=3,111; 37.9% and palliative n=5,093; 62.1%); ESCC (n=1,120; 13.7%), EAC (n=2,065; 25.2%), GEJC (n=1,538; 18.7%), and GC (n=3,481; 42.4%). Approximately 36.4%–40.4% of patients received curative treatment; predominantly definitive SACT + RT (n=282; 62.3%) in ESCC, SACT + RT/surgery (n=238; 29.9%) in EAC, SACT/surgery (n=295; 49.6%) in GEJC, and primary surgery (n=761; 60.1%) in GC. Patients with EAC and GEJC treated with SACT + RT/surgery had a median OS of 49 months [95% CI: 39.0, 75.1] and 42 months [95% CI: 35.1, NE], respectively, compared with 86 months [95% CI: 51.1, NE] and 75 months [95% CI: 49.1, NE] in those treated with SACT/surgery (Cox regression to be presented).ConclusionsPatients with GEJC and EAC treated with curative SACT/surgery in Norway may have improved survival outcomes compared with those who received treatment with SACT + RT/surgery. However, these RWE results may be subject to several confounding factors.Editorial acknowledgementEditorial assistance and medical writing support was provided by Carla De Villiers and Robert Jenkins of Health Economics and Outcomes Research (HEOR) Ltd.Legal entity responsible for the studyBristol Myers Squibb.FundingBristol Myers Squibb.DisclosureG.O. Hjortland: Financial Interests, Institutional, Funding, BMS has supported another study with free drug supply: Bristol Myers Squibb. G. Emanuel, M. Ulvestad: Financial Interests, Institutional, Full or part-time Employment: Bristol Myers Squibb. All other authors have declared no conflicts of interest.