Why carry out this study?

Clinical management of locally advanced, unresectable, or metastatic (adv/met) esophageal adenocarcinoma (EAC) generally follows the recommendations for adv/met gastric cancer (GC) and adv/met gastroesophageal junction cancer (GEJC).

Few studies have assessed whether patients receiving first-line therapy for adv/met GC/GEJC and adv/met EAC have similar demographics, treatment patterns, and clinical outcomes in routine clinical practice.

What was learned from the study?

In this real-world analysis of electronic health records, there were some minor underlying demographic differences between patients with adv/met GC/GEJC and adv/met EAC; patients with EAC were more likely to be male, have a history of smoking, have a higher body weight and body mass index, and were less likely to be Hispanic/Latino or Medicaid enrollees.

Both groups of patients appeared to receive comparable treatment in real-world practice, with fluoropyrimidine plus platinum combinations the most frequent first-line regimen in both groups; over one-third of patients in each group (36%) received these agents.

Median OS was broadly similar for those who were diagnosed with adv/met GC/GEJC (9.7 months) and those with adv/met EAC (9.1 months); Cox regression indicated that survival was not associated with the primary site of disease (GC/GEJC vs. EAC).

Time to next treatment and progression-free survival were also similar between patients with adv/met GC/GEJC and those with adv/met EAC.

In real-world clinical practice, patients with EAC are treated similarly to those with adv/met GC/GEJC, and have similar outcomes; patients with adv/met EAC should therefore be included in clinical trials of adv/met GC/GEJC.