Meeting
2016 ASCO Annual Meeting
Impact of early tumor response on prognostic of patients with unresectable liver metastases from wt-KRAS colorectal cancer (LM-CRC) treated with hepatic artery infusion of irinotecan, 5-fluorouracil and oxaliplatin plus intravenous cetuximab after failure of systemic chemotherapy (European Phase II OPTILIV).
Authors
Mohamed Bouchahda
Medical Oncology Department, INSERM U935, Paul Brousse Hospital, Villejuif, France
Mohamed Bouchahda , Valerie Boige , Denis Michel Smith , Abdoulaye Karaboué , Mohamed Hebbar , Céline Lepère , C. N. J. Focan , Rosine Guimbaud , Pasquale F. Innominato , Sameh Awad , Carlos Carvalho , Salvatore Tumolo , Stephanie Truant , Thierry De Baere , Denis Castaing , Philippe Rougier , Julien Taïeb , Jean F. Morere , Michel Ducreux , Francis Levi
Organizations
Medical Oncology Department, INSERM U935, Paul Brousse Hospital, Villejuif, France, Service d'Oncologie Digestive, Gustave Roussy, Villejuif, France, Hopital Saint André, Bordeaux, France, AK-SCIENCE, Vitry Sur Seine, France, University Hospital, Marcq En Baroeul, France, Hôpital Européen Georges Pompidou, Paris, France, Department of Oncology, Centre Hospitalier Chrétien, Clinique Saint-Joseph, Liege, Belgium, University Hospital of Rangueil, Toulouse, France, Warwick Medical School, Coventry, United Kingdom, Radiology Department, Paul Brousse Hospital, Villejuif, France, Medical Oncology Unit, Hospital Fernando Fonesca, Amadora, Portugal, Policlinico Sangiorgio, Pordenone, Italy, Centre Hospitalier Universitaire Lille, Lille, France, Department of Radiology, Gustave Roussy, Cancer Campus, Grand Paris, Villejuif, France, Centre Hépato-Biliaire, AP-HP, Hôpital Paul Brousse, Villejuif, France, Hopital Europeen Georges Pompidou, Paris, France, Paul Brousse Hospital, Villejuif, France, Institut Gustave Roussy, Service d'Oncologie Digestive, Villejuif, France, Hôpital Paul Brousse, Villejuif, France
Research Funding
Other
Background: Early tumor shrinkage has been associated with improved long-term outcome in patients (pts) with chemotherapy (chemo)-refractory LM-CRC. We examined the prognostic relevance of early tumor response after hepatic artery infusion of triplet chemotherapy combined with intravenous (IV) Cetuximab (Cet) in pts with unresectable LM-CRC. Methods: Pts received IV-Cet (500 mg/m2) and HAI of Irinotecan (180mg/m2), 5–Fluorouracil (2800 mg/m2), and Oxaliplatin (85mg/m2) every two weeks. Tumor response (RECIST) was based on CT scans ± MRI q3 courses. Pts were categorized as early-responders (CR or PR after 3 courses – at » 6 weeks), late responders (CR or PR > 3 courses) and non-responders (SD or PD). The rate of conversion to liver surgery (R0-R1), progression free survival (PFS) and overall survival (OS) were compared. Results: 57/64 registered pts (89%) received ³ 3 courses. They were assessed for response, which occurred early for 16/57 pts (28%), late for 10 pts (17.5%) or not at all for 31 pts (54.4%). The early-responders had similarly extensive disease as the other pts (median of 12 LM, median largest diameter = 37 mm, bilateral LM for 81% pts). Grade 3-4 diarrhea and asthenia were least in the early responders (6.3% vs 22.0%, and 0% vs 26.8%, p = 0.024, respectively).R0-R1 resection rate was twice as high in the early response group as compared to the other group (7/16; 48,8% vs 10/41; 24,4%, p = 0.10). PFS curves did not differ. In contrast. median OS was significantly longer in the 16 early-responders - 34.5 months [32.1 -36.9] - as compared to both the 41 non-early responders - 20.2 [13.6 – 26.8]; p = 0.010); and the 10 late responders - 12.0 [6.9 -17.2]; p = 0.001. Conclusions: Best clinical tolerability, LM conversion-to-resection, and survival outcomes were obtained in pts achieving an early tumor response on combined triplet hepatic artery infusion and IV Cet. The rapid disease-modifying effect of HAI is an important asset for curative intent medico-surgical strategies, and awaits prospective confirmation. Clinical trial information: NCT00852228
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Abstract Details
Session Type
Publication Only
Session Title
Publication Only: Gastrointestinal (Colorectal) Cancer
Track
Gastrointestinal Cancer—Colorectal and Anal
Sub Track
Colorectal Cancer–Advanced Disease
Clinical Trial Registration Number
NCT00852228
Citation
J Clin Oncol 34, 2016 (suppl; abstr e15036)
DOI
10.1200/JCO.2016.34.15_suppl.e15036
Abstract #
e15036
Abstract Disclosures
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