Aims

In England, not all cancer drugs are routinely funded; new medicines are first appraised by the National Institute for Health and Care Excellence. Funding can be temporarily given through the Cancer Drugs Fund while further information is collected. The Systemic Anti-Cancer Therapy (SACT) dataset collects information on all patients receiving chemotherapy in England. To date, little has been published, despite concerns that real-world effectiveness of medicines may be inferior to that seen in clinical trials. The aim of the present study was to establish the feasibility of using our local copy of routinely collected SACT data for the evaluation of outcomes, using the data within the context of gastrointestinal cancers.

Materials and methods

We used our local SACT dataset submissions from three National Health Service trusts, with a reproducible method of data linkage, to undertake a cohort analysis of treatment duration and overall survival for cetuximab, panitumumab, trifluridine/tipiracil (all three in colorectal cancer), sorafenib (in hepatocellular cancer) and nab-paclitaxel (nanoparticle albumin-bound paclitaxel) with gemcitabine (in pancreatic cancer) for all patients treated from May 2016 to March 2021.

Results

In our population, epidermal growth factor receptor inhibitors and trifluridine/tipiracil and sorafenib performed similarly to expected but nab-paclitaxel with gemcitabine in pancreatic cancer seemed to be no better than gemcitabine alone, when given within the current funding arrangements in England.

Conclusions

Our results support the publication of national outcome data. If these results are confirmed on a larger cohort, it would support the reappraisal of certain drugs and provide further evidence to clinicians and patients when deciding the best treatment.

中文翻译：

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使用上传到英格兰全身抗癌治疗数据集的本地数据对癌症药物进行真实世界评估

宗旨

在英格兰，并非所有的抗癌药物都得到常规资助；新药首先由国家健康与护理卓越研究所进行评估。在收集更多信息的同时，可以通过癌症药物基金暂时提供资金。全身抗癌治疗 (SACT) 数据集收集了英格兰所有接受化疗的患者的信息。迄今为止，尽管担心药物在现实世界中的有效性可能不如临床试验中所见，但发表的内容很少。本研究的目的是确定使用我们常规收集的 SACT 数据的本地副本来评估结果的可行性，使用胃肠道癌症背景下的数据。

材料和方法

我们使用来自三个国家卫生服务信托机构的本地 SACT 数据集提交，采用可重现的数据链接方法，对西妥昔单抗、帕尼单抗、曲氟尿苷/替吡嘧啶（所有三种用于结直肠癌）、索拉非尼的治疗持续时间和总生存期进行队列分析2016 年 5 月至 2021 年 3 月接受治疗的所有患者（肝细胞癌）和白蛋白结合紫杉醇（纳米颗粒白蛋白结合紫杉醇）与吉西他滨（胰腺癌）。

结果

在我们的人群中，表皮生长因子受体抑制剂和曲氟尿嘧啶/tipiracil 和索拉非尼的表现与预期相似，但在英国目前的资助安排下，白蛋白结合型紫杉醇联合吉西他滨治疗胰腺癌似乎并不比单独使用吉西他滨好。

结论

我们的结果支持国家结果数据的发布。如果这些结果在更大的队列中得到证实，它将支持对某些药物的重新评估，并在决定最佳治疗时为临床医生和患者提供进一步的证据。