Cetuximab, panitumumab and bevacizumab for metastatic colorectal cancer
Page last updated: 22 August 2018
Drug utilisation sub-committee (DUSC)
February 2018
Abstract
Purpose
To assess the utilisation of targeted therapies for metastatic colorectal cancer (mCRC) including PBS listed bevacizumab, cetuximab and panitumumab.
|
First listing date or date of listing amendment(s) |
Listing details (abridged) |
|---|---|
|
1 July 2009 |
Bevacizumab in combination with first-line chemotherapy of a patient with previously untreated metastatic colorectal cancer with a WHO performance status of 0 or 1. |
|
1 September 2011 |
Cetuximab as monotherapy or in combination with an irinotecan based therapy, of a patient with a WHO performance status of 2 or less and with KRAS wild type metastatic colorectal cancer after failure of first-line chemotherapy. |
|
1 April 2014 |
Panitumumab as monotherapy or in combination with an irinotecan based therapy, of a patient with a WHO performance status of 2 or less and with KRAS wild-type metastatic colorectal cancer after failure of first-line chemotherapy. |
|
1 January 2015 |
Amendment to the restrictions for panitumumab and cetuximab to include only patients with rat sarcoma proto-oncogene wild type (RAS WT) status rather than Kirsten RAS wild type (KRAS WT) status. This was in response to evidence which indicated that continuing the current restrictions based on identifying KRAS wild-type patients may expose some of patients to worse health outcomes. |
|
1 February 2015 |
The listings for bevacizumab, cetuximab and panitumumab on the Section 100 – Efficient Funding of Chemotherapy (Private Hospital/Private Clinic) Schedule were changed from Authority required to Authority required (STREAMLINED). This was to make the listings consistent with the Authority required (STREAMLINED) items for prescribers in public hospitals. |
|
1 June 2015 |
Cetuximab for first-line treatment for metastatic colorectal cancer in combination with first-line chemotherapy.
Bevacizumab in combination with second-line chemotherapy of a patient with RAS wild type metastatic colorectal cancer with a WHO performance status of 0 or 1 after failure of first-line anti-EGFR antibodies. |
|
1 October 2015 |
Panitumumab in combination with first-line chemotherapy of a patient with RAS wild-type metastatic colorectal cancer with a WHO performance status of 0 or 1. |
Data Source / methodology
Data to assess utilisation was obtained from the Department of Human Services (DHS) PBS prescription claims database.
Key Findings
- The overall utilisation of bevacizumab, cetuximab and panitumumab had stabilised by 2016. In 2016, a total of 5,177 patients were treated for metastatic colorectal cancer with these medicines. Of these, the number of patients first initiating targeted therapy was 2,479.
- The time on treatment with bevacizumab in first-line (~427 days) was longer than the progression-free survival reported in key clinical trials (~340 days). Further, around 11 percent of patients were identified as having been supplied bevacizumab with different chemotherapy partners. These findings suggest that there may have been some use of bevacizumab in patients with progressive disease.
- There were no cases identified where bevacizumab, cetuximab or panitumumab were potentially co-administered with each other.
