In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 4_suppl ( 2017-02-01), p. 744-744
Abstract:
744 Background: Bevacizumab (BV) plus fluoropyrimidine-based chemotherapy is a standard treatment as first-line therapy for metastatic colorectal cancer (mCRC). In phase 3 studies, addition of BV to doublet chemotherapy significantly improved progression-free survival (PFS), otherwise overall survival (OS) differences didn’t reach statistical significance. There are only a few reports that assess the efficacy of BV containing chemotherapy according to KRAS status. Methods: We retrospectively reviewed the data of mCRC patients who received doublet chemotherapy (FOLFOX/CapeOX/SOX/FOLFIRI/IRIS) with or without BV as first-line therapy in Aichi Cancer Center or Shizuoka Cancer Center between Apr. 2007 and Aug. 2014. Patients fulfilled following criteria: histologically proven adenocarcinoma, ECOG PS 0-1, adequate organ functions. Exclusion criteria were as follows: KRAS status unknown, adjuvant chemotherapy within less than 6 months (M) before relapse, doublet chemotherapy with other biologics. We analyzed the efficacy of doublet chemotherapy with BV (Group A) and without BV (Group B), dividing into KRAS exon 2 wild type (WT) and mutant (MT). WT-A means Group A in WT. Results: Patients met the selection criteria were 578 (WT-A/WT-B 276/55, MT-A/MT-B 202/45). Patients’ backgrounds were as follows; median age (range) 63 (20-88) years old, male/female 60/40%, ECOG PS 0/1 66/34%, tumor location right colon/left colon and rectum 29/71%, number of metastases 1/ ≥ 2 48/52%, KRAS status WT/MT 57/43%. PFS in Group A/B was 13.0/8.4 m (HR 0.49, 95%CI 0.39-0.61, p 〈 0.0001), and OS was 32.4/27.1 m (HR 0.70, 95%CI 0.56-0.88, p = 0.0024). PFS was 12.7/8.5 m in WT-A/WT-B (HR 0.51, 95%CI 0.38-0.69, p 〈 0.0001), 14.5/8.0 m in MT-A/MT-B (HR 0.46, 95%CI 0.33-0.64, p 〈 0.0001). OS was 32.6/29.8 m in WT-A/WT-B (HR 0.85, 95%CI 0.62-1.17, p = 0.32), 31.7/25.8 m in MT-A/MT-B (HR 0.55, 95%CI 0.39-0.77, p = 0.0005), adjusted HR (variables: age, sex, ECOG PS, tumor location, et al) was 0.74 in WT (95%CI 0.53-1.05, p = 0.089), 0.69 in MT (95%CI 0.48-1.00, p = 0.047). Conclusions: Addition of BV to doublet chemotherapy as first-line therapy might prolong OS in patients with mCRC regardless of KRAS status.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2017.35.4_suppl.744
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2017
detail.hit.zdb_id:
2005181-5
