# Continuum of care and survival in patients with metastatic colorectal cancer: results of the real-world prospective, longitudinal cohort PROMETCO study

## TL;DR

The PROMETCO study tracked real-world treatment patterns and survival outcomes for metastatic colorectal cancer patients across multiple therapy lines.

## Contribution

This is the first international, prospective study to investigate the continuum of care for metastatic colorectal cancer in a real-world setting.

## Key findings

- Median overall survival from diagnosis was 36.4 months, with treatment patterns aligning with guidelines.
- Median progression-free survival decreased from first-line to third-line treatment and remained stable beyond.
- Survival outcomes were comparable to long-term clinical trial data.

## Abstract

PROMETCO is the first international, prospective study investigating the continuum of care, including prescribing patterns, efficacy and safety in patients with metastatic colorectal cancer (mCRC) at later therapy lines in a real-world setting.

Adults with mCRC and two disease progressions since diagnosis of mCRC who were willing to receive subsequent treatment and gave informed consent were included. The study consisted of retrospective medical chart data collection pre-inclusion and a prospective observational period post-inclusion. Endpoint data presented include patient characteristics, treatment patterns and efficacy including progression-free survival (PFS) per treatment line and overall survival (OS).

As of July 2023, 738 mCRC patients from 96 centres in 18 countries were recruited. 48.9% of patients had RAS-mutated and 5.0% BRAF-mutated mCRC. Between mCRC diagnosis and death or withdrawal, patients were frequently exposed to fluoropyrimidine (99.0%), irinotecan (96.2%), oxaliplatin (88.4%), anti-vascular endothelial growth factor (78.7%) and anti-epidermal growth factor receptor (40.1%). Median OS was 36.4, 7.1, and 6.6 months from mCRC diagnosis, inclusion into PROMETCO and third-line (3L) treatment initiation, respectively. Median PFS decreased significantly from first-line (9.2 months) to 3L (2.7 months) and remained consistent from 3L to sixth-line treatment (∼2.3 months). Median OS from diagnosis was 32.7, 26.8, and 40.6 months in RAS-mutated, BRAF-mutated, and RAS/BRAF wildtype mCRC patients, respectively.

PROMETCO provided information on real-world prescribing patterns and efficacy. OS from mCRC diagnosis and PFS from 3L and beyond were similar to previous long-term follow-up data from clinical trials.

•PROMETCO investigated treatment patterns throughout the continuum of care in metastatic colorectal cancer.•Treatment exposure in the 738 patients was largely as expected if guidelines were adhered to.•Median OS from diagnosis and 3L treatment initiation was 36.4 months and 6.6 months, respectively.•Median PFS decreased from 1L to 3L, then was consistent up to and including sixth-line.•Survival results were similar to previous long-term follow-up data from clinical trials.

PROMETCO investigated treatment patterns throughout the continuum of care in metastatic colorectal cancer.

Treatment exposure in the 738 patients was largely as expected if guidelines were adhered to.

Median OS from diagnosis and 3L treatment initiation was 36.4 months and 6.6 months, respectively.

Median PFS decreased from 1L to 3L, then was consistent up to and including sixth-line.

Survival results were similar to previous long-term follow-up data from clinical trials.