On-treatment changes of plasma protein biomarkers in CALGB/SWOG 80405 (Alliance).

Authors

null

Ace Joseph Hatch

Duke University, Durham, NC

Ace Joseph Hatch , Fang-Shu Ou , Tyler Zemla , Mark D. Starr , John C. Brady , Yingmiao Liu , Federico Innocenti , Jeffrey A. Meyerhardt , Eileen Mary O'Reilly , Heinz-Josef Lenz , Herbert Hurwitz , Alan P. Venook , Andrew B. Nixon

Organizations

Duke University, Durham, NC, Mayo Clinic, Rochester, MN, Duke University Medical Center, Durham, NC, The University of North Carolina at Chapel Hill, Chapel Hill, NC, Dana-Farber Cancer Institute/ Partners Cancer Care, Boston, MA, Memorial Sloan Kettering Cancer Center, New York, NY, University of Southern California, Los Angeles, CA, University of California San Francisco, San Francisco, CA

Research Funding

Other Foundation

Background: CALGB/SWOG 80405 found no difference in overall survival (OS) or progression-free survival (PFS) in 1137 patients with KRAS wild-type metastatic colorectal cancer (mCRC) treated with either the anti-VEGF agent bevacizumab (Bev) or the anti-EGFR agent cetuximab (Cet) in combination with chemotherapy (FOLFOX or FOLFIRI) as first-line therapy. Additional molecular biomarkers are required for the optimization of treatment choices for patients with mCRC. Methods: Levels of 24 proteins were assayed in EDTA-plasma samples using multiplex ELISA techniques. Plasma samples were collected at baseline and cycle 2 day 1 (C2D1). Analyses of baseline markers have been presented previously. Changes from baseline to C2D1 were expressed as an L-ratio (LR, log2 of C2D1 divided by baseline measure). LRs dichotomized at 0 were analyzed for potential prognostic and predictive effects on OS and PFS using Cox models while adjusting for confounders (post-hoc optimized cutpoints were used for PLGF, TIMP1, VCAM1, and VEGFR3 due to skew in the distributions of these markers). P-values are not corrected for multiple testing. Results: Baseline and matched C2D1 samples from 446 patients (212 Bev/234 Cet) were available for analysis. Thirteen markers were differentially modulated between arms (p < 0.05). Early increases in CD73 (p = 0.001), ICAM1 (p = 0.022), TIMP1 (p = 0.001), TSP2 (p = 0.024), and VEGFR3 (p = 0.006) were prognostic for shorter OS. Increases in ICAM1 (p = 0.008), TIMP1 (p = 0.042), and TGFB1 (p = 0.039) were prognostic for shorter PFS. Changes in VEGFR3 (pint = 0.097) and TGFBR3 (pint = 0.052) were predictive for OS and PFS, respectively. No other markers were predictive for OS or PFS (p < 0.1). Conclusions: Changes in circulating plasma protein biomarkers observed in patients enrolled in CALGB/SWOG 80405 were both prognostic and predictive for OS and PFS and warrant further study. Such changes could provide valuable information and help guide treatment decisions. Support: U10CA180821, U10CA180882, U10CA180888, U10CA180830; ClinicalTrials.gov: NCT00265850.

MarkerEndpointLRHR (CI), Bev vs. CetInteraction P (pint)
VEGFR3OS≥-0.40.53 (0.30-0.94)0.097
<-0.41.06 (0.60-1.86)
TGFBR3PFS≥00.92 (0.64-1.30)0.052
<00.47 (0.26-0.85)

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Abstract Details

Meeting

2019 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

Citation

J Clin Oncol 37, 2019 (suppl 4; abstr 588)

DOI

10.1200/JCO.2019.37.4_suppl.588

Abstract #

588

Poster Bd #

H11

Abstract Disclosures