Work

CB2-04: Use of the Oncology Beacon Module and VDW Data to Identify Variations in Treatment for Advanced Colorectal Cancer

Year: 2012

Type: article

Abstract: BACKGROUND/AIMS: Variation in utilization and costs of chemotherapy agents for colorectal cancer (CRC) patients not captured by SEER-Medicare or clinical trials has not been well studied. Little is known about how chemotherapy is administered to patients with advanced disease who are treated in community practices, including such key factors as treatment intent (curative vs. palliative), dosing, treatment modifications, and discontinuations, and whether patients receive new lines of chemotherapy after failing to respond to prior regimens. AIMS: Using the wealth of cancer treatment data newly available as a result of recent VDW infrastructure development efforts associated with infusion and chemotherapy utilization, we characterize the number of unique chemotherapy protocols and regimens administered to patients with advanced CRC. METHODS: Patients aged > 21 years with stage III or IV CRC, diagnosed between 2007–2010 at three CRN sites were included in the analysis. Using VDW files including tumor registries and data files derived from Kaiser Permanente’s HealthConnect Oncology Beacon® module, patients were followed from diagnosis date through 2010 (or death or disenrollment). We identified and tabulated treatment information including treatment intent, treatment protocols, oral and infused treatment regimens, early cessation and/or dose modification of therapy due to toxicities, and patient characteristics. We also estimate the variation in costs associated with the treatment regimens identified. RESULTS: Preliminary findings suggest that more than 40% of advanced CRC patients receiving chemotherapy were less than 65 years old. For the majority of cases, treatment intent was noted as adjuvant or neo-adjuvant. Chemotherapy treatments were distributed across 14 standard adult oncology protocols. The most common first line treatment was Oxaliplatin + Fluorouracil + Leucovorin. However, a large number of regimens included the monoclonal antibody, bevacizumab. A number of cases were noted to have treatment plan changes and modifications. Treatment costs were positively correlated to the use of regimens that included bevacizumab. DISCUSSION: Newly available VDW chemotherapy infusion data derived from the EpicCare and Kaiser Permanente’s HealthConnect Oncology Beacon® files (along with other infusion data sources) is a rich cancer treatment data source that researchers can use to conduct clinical- and policy-relevant comparative effectiveness research studies in patients with advanced colorectal cancer.

Source: Clinical Medicine & Research

DOI: 10.3121/cmr.2012.1100.cb2-04