In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 15_suppl ( 2012-05-20), p. e14162-e14162
Abstract:
e14162 Background: Preoperative application of cetuximab and radiochemotherapy combined with 5-FU+oxaliplatin (CET-CAPOX-RT-phase-I/II-study) failed to increase the complete remission rate (pCR, primary endpoint) in rectal cancers. Here, we report longterm survival in respect of biomarkers. Methods: In 45 of 53 patients (85%) total mesorectal excision (TME) was performed with curative intention. Disease-/progression-free survival (DFS/PFS) and overall cancer specific survival (CSS) were correlated with clinicopathological findings (e.g. tumor regression grading (TRG), KRAS-, HER-2-, Ki67-, EGFR-, IGF1R-, Src-, PTEN-, Survivin-, XIAP- and thymidylatesynthase(TS)-status). Results: After triple RCT, ypUICC stages were 0 (4x), I (17x), II (10x), III (14x) and IV (7x); RCT-induced T-level- (49%) and UICC-downcategorizing (53%) correlated with major (38% TRG 3-4) versus minor response (62.3% TRG 0-2) (p=0.005 and p=0.02, respectively). During follow-up (63 months) 7/53 patients with M1-status at surgery died. In 45 patients with M0-status no locoregional failure but in 5 patients metastatic recurrences were detected. DFS at 1, 3 and 5 years was 90.7% (CI: 82.5-99.8), 88.3% (CI: 79.2-98.5) and 88.3% (CI: 79.2-98.5); the CSS was 97.6% (CI: 93.1-100), 95.2% (CI: 89-100), and 90.3% (CI: 82-99.8), respectively. Patients with ypN0-status demonstrated better DFS (p=0.027), PFS (p=0.024) and CSS (p=0.016). KRAS mutations (33%) had no prognostic influence but a positive HER-2-status (18%) seemed to be associated with better CSS (p=0.11). High Ki-67-expression (p=0.09) as well as the loss of RCT-induced Survivin-downregulation (p=0.05) correlated with reduced CSS. No prognostic influence was found for EGFR-, IGF1R-, Src-, PTEN-, XIAP- and TS-expression. Conclusions: The disappointing pCR rate of the CET-CAPOX-RT-phase-I/II-study did not translate to poor longterm survival.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2012.30.15_suppl.e14162
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2012
detail.hit.zdb_id:
2005181-5
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