Burden of illness in second-line colorectal cancer: A systematic literature review.

Abstract

e14061 Background: Colorectal cancer (CRC) is the third and second most common cancer in males and females, respectively, worldwide. Based on cases diagnosed in 2008, the age-adjusted incidence rate of CRC was 47.2/100,000/year in the US. Approximately 15-25% of all new cases are diagnosed with metastases and half of all cases result in metastases, representing an increased health and economic burden. The objective of this study was to gain a more in-depth understanding of the epidemiology, clinical and economic burden of second-line CRC in the US, Europe big 5, BRIC-M countries, and Japan. Methods: A Cochrane standard systematic literature review was performed using EMBASE, PubMed, NHSEED databases, and data from key congresses. Searches were conducted using specifically tailored search algorithms for years 2006-2011. Results: Of the 1,377 citations reviewed, 10 studies were identified (6 were epidemiology studies). No information on the number of patients treated for second-line mCRC was found. Estimates of median overall survival were short and varied from 7-18.7 months. New chemotherapy regimens, younger patients, and patients without KRAS mutations are associated with longer overall survival. Information on clinical burden of disease was also limited. The majority of patients presented with liver metastases (73%) and cardiovascular disease (63%). Three clinical trials evaluated quality of life (QoL) with significant heterogeneities in study design, population, treatment regimens and assessment instruments used. No statistically significant results favored targeted therapy. Only 1 study conducted in the US assessed economic burden in patients treated with either bevacizumab or cetuximab. At 6 months the total health care cost was $73,712 and $81,781 respectively, with main cost drivers being outpatient and targeted therapy costs. Conclusions: A substantial evidence gap regarding knowledge of burden of illness in second-line mCRC limits informed clinical and economic decision making. Further research is required to evaluate country-specific epidemiologic and survival data, QoL, resource utilization and cost variation associated with active treatment and end of life care. Research funded by Sanofi/Regeneron.

Application of ultrasound in the diagnosis of gastrointestinal tumors

“…30 Its incidence rate ranks third among men and second among women, which brings a heavy burden to society. 31 Although these patients undergo radical surgery, the recurrence and metastasis rate are higher and the prognosis is worse. 32 Therefore, it is of great clinical significance to explore good early diagnosis methods and improve the early diagnosis of CRC.…”