OBJECTIVES: Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in Germany, moreover it has been reported that a substantial percentage of patients are identified with metastases upon first diagnosis. As real-world data in this patient group is scarce, the study aims a better understanding of the treatment landscape and patterns in Germany.

METHODS: The study population is based on claims data of the Gesundheitsforen Leipzig database (2.4 Mio. insured persons included per year). Inpatient and outpatient incident mCRC patients in 2016 were included. The primary objective investigated the number of patients in first and second line per therapy and the median outpatient treatment duration. As secondary objectives treatment settings and the number of patients with FOLFOX regime and de-escalation were described.

RESULTS: Of 798 identified mCRC patients 28% (N=223) received outpatient treatment in 1L and 10% (N=79) in 2L. Most often FOLFOX (35%; N=77), capecitabine (18%; N=40) and combinations with monoclonal antibodies (mAb) (12%; N=27) were used in 1L. In 2L FOLFIRI+Bevacizumab (15%; N=12), FOLFOX+Bevacizumab (7%; N=7) and FOLFIRI+Cetuximab (7%; N=7) were the most frequently reported treatments. Median outpatient treatment duration in both lines was about 5 months each and 7% of patients were de-escalated.

CONCLUSIONS: According to our analysis, outpatient treatment in the period 2016 consisted of more traditional regimes, whereas the extent of targeted therapies with mAb was limited. Additionally, the transition to de-escalating maintenance therapy as recommended in guidelines was applied for only a few patients.