OBJECTIVES: Community health systems (CHS) in the US play a large role in the care of patients with cancer, with over 50% of patients with cancer cared for in CHS. The systemic treatments used among patients with advanced colorectal cancer seen in these CHS are not widely published. This analysis describes the systemic treatment utilization of these patients treated across a sample of CHS.

METHODS: A retrospective analysis was performed utilizing the Syapse Learning Health Network^TM (LHN), an electronic medical record (EMR) derived database that collects cancer care data from multiple care settings within CHS across 33 states, 450+ hospitals and from patients cared for by 1,900+ oncologists. Patients >18 yo at advanced colorectal cancer diagnosis (IIIB+) from January 1, 2017 through December 13, 2021 were identified from the LHN using ICD-10 codes. Data utilized for this analysis included both structured (set EMR fields like sex and birth date) and unstructured data (e.g. physician notes) validated by Syapse’s Certified Tumor Registrars and then descriptively summarized.

RESULTS: 4,738 patients from the LHN with advanced colorectal cancer (stage IIIB+) were included in the analysis. 2,825 patients (60%) received antineoplastic systemic treatment; in the 1L setting 95% received chemotherapy, and 29% received targeted therapy, 4% received hormone therapy and 2% received immunotherapy. Agents included: oxaliplatin,73%; 5-fluorouracil, 71%; leucovorin, 64%; bevacizumab, 24%; capecitabine,13%; and irinotecan, 8%.

CONCLUSIONS: Consistent with management guidelines, patients with advanced colorectal cancer treated within CHS were most likely to receive 5-fluorouracil, leucovorin and oxaliplatin based chemotherapy in the 1L setting, though oral fluoropyrimidines had low usage. There was also relatively low usage of irinotecan. Further analysis is needed to better understand management decisions for this patient group cared for within CHS