Metastases resection after FOLFIRI-aflibercept (FA) in oxaliplatin-refractory colorectal cancer patients (ORF-CRC).

Authors

null

Andres J. Muñoz Martín

Hospital General Universitario Gregorio Marañón, Madrid, Spain

Andres J. Muñoz Martín , Silvia Garcia Adrian , Carles Pericay , Ana Ruíz , Patricia Ibeas , Rosana Grandez , Elena Diaz Pena Jr., Ana Maria Lopez , Juez MARTEL Ignacio , Irene Gonzalez Cebrian , Sara Encinas García , Julia Alcaide , Ana Fernandez Fernandez Montes , Carmen Soriano , Teresa Mercade Macarulla , Beatriz García-Paredes , Gema Pulido , Jose M. Mazo , Nuria Rodriguez Salas , Pilar Garcia Alfonso

Organizations

Hospital General Universitario Gregorio Marañón, Madrid, Spain, Hospital Universitario de Mostoles, Mostoles, Spain, Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Spain, Hospital Universitario Puerta de Hierro, Madrid, Spain, H. Universitario del Henares, Majadahonda, Spain, Hospital Reina Sofía, Tudela, Spain, H. Don Benito-Villanueva Badajoz, Seville, Spain, Hospital Universitario de Burgos, Burgos, Spain, Hospital Fuenlabrada, Fuenlabrada, Spain, Hospital Virgen de las Nieves, Granada, Spain, University of Texas MD Anderson Cancer Center International, Madrid, Spain, Hospital Costa del Sol, Marbella, Spain, Santa Maria Nai, Ourense, Spain, Hospital Virgen de La Luz, Cuenca, Spain, Vall d’Hebron University Hospital Institute of Oncology, Barcelona, Spain, Hospital Clínico San Carlos, Madrid, Spain, University Reina Sofía Hospital, Cordoba, Spain, Hospital de Llerena, Llerena, Spain, Hospital Universitario La Paz, Madrid, Spain

Research Funding

Other

Background: Recent data suggest resection of colorectal metastases after second-line chemotherapy offers similar overall survival (OS) benefit compared to what described in first-line. The improvement in response rate with FA in second-line may increase the number of patients eventually undergo metastases resection. Methods: We performed a retrospective analysis of 32 patients from 26 Spanish hospitals who underwent surgical resection after FA in ORF-CRC in real-life setting. Our aim was to analyze the impact of metastases resection in different organs (liver, lung, etc.) in terms of OS and progression-free survival (PFS) and post-surgical mortality and morbidity. Results: Clinical characteristics: Median age: 65 years (43-83). Sex: 78.1% male, 21.9% female. ECOG 0/1 53.1/46.9%. Ras: wild-type/mutated 25/75%. Type of tumor: colon 75.0%, rectal 25.0%. Location: right 28.1%, transverse 9.4%, and left-side 62.5%. Previous treatment: oxaliplatin combinations (100%), bevacizumab 37.5%, cetuximab 21.97%. Ras wild-type patients received previous anti-EGFR therapy. FA in second-line 93.7% and beyond second-line 6.3%. Median FA cycles before surgery: 6.5 (range 3-44). Type of surgery: liver metastases 46.9%, lung metastases 25.0%, cytoreductive surgery for peritoneal carcinomatosis 15.6%, supraadrenalectomy 3.1%, simultaneous liver and peritoneal carcinomatosis 9.4%. Better tumor response with FA (RECIST1.1): partial response 56.3%, complete response 3.1%, stable disease 40.6%. Median follow-up: 20.9 months [m] (range 3.8-57.3 m). Median PFS from surgery: 8.0 m (confidence interval [CI] 95% 2.5-13.5 m). Median OS from surgery: 37.3 m (CI 95% 23.3-51.4 m). No significant difference between right and left-side tumors in OS or PFS were observed. 90-day postoperative mortality/morbidity: 18.8/0% Reoperation rate: 9.4%. Resection rates: R0 75.0%, R1 15.6%, R2 9.4%. Aflibercept after surgery: 22% patients. Conclusions: Metastases resection following FA in ORF-CRC offers encouraging OS with favorable surgical mortality and morbidity. Salvage surgery should be considered in highly selected patients in second-line setting with oligometastatic disease.

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Abstract Details

Meeting

2018 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Cancers of the Colon, Rectum, and Anus

Track

Cancers of the Colon, Rectum, and Anus

Sub Track

Multidisciplinary Treatment

Citation

J Clin Oncol 36, 2018 (suppl 4S; abstr 862)

DOI

10.1200/JCO.2018.36.4_suppl.862

Abstract #

862

Poster Bd #

P14

Abstract Disclosures

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