Treatment of Metastatic Colorectal Cancer in the Real World (mCRC): Final Results from a European Survey

Abstract

Introduction: EuropaColon, a European CRC patient organization, planned and executed a survey in 15 European countries on the Unmet Needs of Patients Living with mCRC. The aim was to better understand the challenges and needs of those living with mCRC and their health-related quality of life. Recruitment has been completed. The objective of this work is to report answers to questions related to treatment in the recruited population. Methods: IRB approval, where needed, was sought for the survey. Clinicians and nurses together with partner organizations of EuropaColon helped to recruit patients. The treatment section comprised of 21 questions, including the time gap between the diagnosis and treatment, multidisciplinary team (MDT) discussion, type of treatment received and treatment and side-effect information provided. As preferred, patients could complete the survey on paper or online. Single data entry from the paper surveys was done by EuropaColon. Descriptive analyses were carried out in Excel. Response rates below refer to those who provided answers (% of non-missing values). Results: Altogether, 883 surveys were collected and analyzed, with 170 from Serbia, 163 from Poland, 112 from Spain, 103 from Hungary, 65 from Belgium, 57 from Cyprus, 53 from the UK, 40 from the Netherlands, 36 from Italy, 26 from Turkey, 24 from Portugal, 22 from Germany, 8 from Austria, 3 from Ireland and 1 from Norway. Completion rates varied across questions, but in general, were high. Majority of responders were treated in a public hospital (85%). Most patients in all countries were undergoing treatment at the time of survey completion (65-70%), except for the UK, where 64% of patients already completed therapy and had no evidence of disease. Most patients received treatments within 1-3 months after diagnosis: 22% within first 2 weeks, 36% 2 weeks-1month and 29% between 1-3 months. Overall, 65% reported that their treatment was discussed by a MDT and that they were informed about the outcome of that meeting. About half of all responders thought their views were considered before starting the treatment, with variation across countries: 90% in Belgium and Spain and only 53% in Serbia. Most patients got surgery and chemotherapy (81% and 90%) while 20% received radiotherapy and 11% got a targeted therapy. Patients were able to specify whether they got chemo-or targeted agent, but not to name specific therapies. Patients were relatively well-informed about side effects (76%). A fifth of patients knew they received a molecular test, ranging from a low 6% in Serbia up to 67% in Ireland. Conclusion: Degree of information surveyed across 15 European countries varies. Patients know about MDT and appear to be informed about side effects they can expect. However, the specific treatment received is not well known, and familiarity with molecular testing is minimal. Overall results mask marked variations across countries that will need to be investigated. Study limitations include a cross-sectional design and single data entry.