Plasma VEGF-A (pVEGF-A) level in efficacy analysis of metastatic colorectal cancer patients (mCRC) treated with mFOLFOX6/XELOX plus bevacizumab (BV) (WJOG7612GTR).

Authors

null

Wataru Okamoto

National Cancer Center, Kashiwa, Japan

Wataru Okamoto , Akitaka Makiyama , Yoshiyuki Yamamoto , Kohei Shitara , Tadamichi Denda , Naoki Izawa , Yasuyuki Nakano , Tomohiro Nishina , Taito Esaki , Hiroki Hara , Yukinori Ozaki , Hiroyuki Okuda , Narikazu Boku , Ichinosuke Hyodo , Kentaro Yamazaki , Shuichi Hironaka , Kazuko Sakai , Takeharu Yamanaka , Kei Muro , Kazuto Nishio

Organizations

National Cancer Center, Kashiwa, Japan, Kyushu Hospital, Kitakyushu, Japan, University of Tsukuba, Tsukuba, Japan, National Cancer Center Hospital East, Kashiwa, Japan, Chiba Cancer Center, Chiba, Japan, St. Marianna University School of Medicine, Kawasaki, Japan, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan, National Kyushu Cancer Center, Fukuoka, Japan, Saitama Cancer Center, Saitama, Japan, Toranomon Hospital, Tokyo, Japan, Keiyukai Sapporo Hospital, Sapporo, Japan, National Cancer Center Hospital, Tokyo, Japan, Shizuoka General Hospital Cancer Center, Shizuoka, Japan, Kindai University, Osaka, Japan, Yokohama City University School of Medicine, Yokohama, Japan, Aichi Cancer Center Hospital, Nagoya, Japan

Research Funding

Pharmaceutical/Biotech Company

Background: Plasma levels of VEGF-A short isoforms (VEGF-A110 and -A121) measured by immunological multiparametric chip technique (IMPACT) were reported to be associated with clinical benefits from bevacizumab (BV) in advanced gastric and pancreatic cancer but not in metastatic colorectal cancer (mCRC). Negative results in mCRC studies might be caused by different sample handling: citrate instead of EDTA and repetition of freeze/thaw. Methods: Blood samples were collected in EDTA before the first-line treatment with BV+mFOLFOX6 or +XELOX for mCRC. Plasma samples were analyzed at Roche Diagnostics Ltd. (Penzberg, Germany) using IMPACT-2 (Roche proprietary multiplex enzyme-linked immunosorbent assay platform). A median value of pVEGF-A was used as a cut-off point to categorize patients (pts) into the low and high pVEGF-A groups. Progression free survival (PFS) and overall survival (OS) between the low and high pVEGF-A groups were compared, using Cox proportional hazards model. We hypothesized that BV-containing treatment extend shorter PFS of pts with high pVEGF-A to that with low pVEGF-A, and estimated a threshold hazard ratio (HR) between them as below 1.15. Results: Among 102 pts enrolled between January 2014 and April 2015, 100 (53 BV+mFOLFOX6 and 47 BV+XELOX) were eligible. Median PFS was 11.4 months [95% CI, 9.5-13.0] and response rate was 64.6 % [range, 53.3-74.9]. pVEGF-A was measured in 97 pts and the median value was 36.8 pg/ml [range, 6.5- 262.2]. The hazard ratios of PFS and OS between the high and low pVEGF-A groups were 1.23 [95%CI, 0.76-1.97, p = 0.40] and 2.47 [95%CI, 1.14-5.36, p = 0.02], respectively. Conclusions: mCRC pts with high pVEGF-A showed shorter PFS than those with low pVEGF-A beyond the predefined threshold (HR 1.15) in BV-containing chemotherapy, suggesting that pVEGF-A could not be a predictive marker for BV efficacy. Clinical trial information: UMIN000012442.

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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

Translational Research

Clinical Trial Registration Number

UMIN000012442

Citation

J Clin Oncol 36, 2018 (suppl 4S; abstr 699)

DOI

10.1200/JCO.2018.36.4_suppl.699

Abstract #

699

Poster Bd #

G12

Abstract Disclosures