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Title: Treatment of 5-fluorouracil refractory metastatic colorectal cancer: an Australian population-based analysis.
Austin Authors: Damianovich, D;Adena, M;Tebbutt, Niall C 
Affiliation: Ludwig Institute for Cancer Research, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 6-Feb-2007
Publication information: British Journal of Cancer 2007; 96(4): 546-50
Abstract: Randomised trials have established the importance of oxaliplatin (O) and irinotecan (I) in advanced colorectal cancer (CRC). However, patients enrolled in clinical studies represent a restricted population and little is known about the use of O and I in the general population and the subsequent outcomes outside clinical studies. We used the Australian Health Insurance Commission (HIC) database to describe prescribing patterns of O and I and their impact on survival in all patients with 5-fluorouracil (5-FU) refractory CRC in Australia in 2002 and 2003. In 2999 patients, there was a marked increase in initial treatment with O rather than I; 48% of patients received O first in 2002 vs 66% in 2003 (P<0.001). Overall 40-45% of patients received both O and I; however, younger patients were more likely to receive both drugs (P<0.001). After 5-FU failure and treatment with O or I, the proportion of patients surviving 6 or 12 months was estimated to be 0.67 (95% CI, 0.66-0.69) and 0.42 (95% CI, 0.40-0.44), respectively. Survival was superior for patients who received both O and I; however, the sequence of agents had no impact. Older patients (> or =70 years) had inferior survival no matter which drug was used as initial treatment. Analysis of the Australian HIC database provides a valuable means of assessing patterns of use and outcomes of new therapies.
Gov't Doc #: 17285136
DOI: 10.1038/sj.bjc.6603590
Journal: British Journal of Cancer
Type: Journal Article
Subjects: Age Distribution
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols.adverse effects.therapeutic use
Camptothecin.administration & dosage.adverse effects.analogs & derivatives
Cohort Studies
Colorectal Neoplasms.drug therapy.mortality.secondary
Databases, Factual
Disease Progression
Drug Resistance, Neoplasm
Drug Utilization.trends
Fluorouracil.adverse effects.therapeutic use
Follow-Up Studies
Middle Aged
National Health Programs.statistics & numerical data
Organoplatinum Compounds.administration & dosage.adverse effects
Outcome Assessment (Health Care).statistics & numerical data
Physician's Practice Patterns.trends
Randomized Controlled Trials as Topic.statistics & numerical data
Sex Distribution
Survival Analysis
Appears in Collections:Journal articles

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