The treatment strategy of the second-line chemotherapy for metastatic colorectal cancer (mCRC) patients (pts) with early progression in the first-line chemotherapy with bevacizumab (BEV), BEV beyond progression (BBP), or non-BBP.

Authors

null

Takeshi Kawakami

Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan

Takeshi Kawakami , Shun Yamamoto , Seiichiro Mitani , Taito Esaki , Yasushi Tsuji , Naoki Izawa , Kentaro Kawakami , Yoshiyuki Yamamoto , Akitaka Makiyama , Kentaro Yamazaki , Toshiki Masuishi , Takako Eguchi Nakajima , Hiroyuki Okuda , Toshikazu Moriwaki , Narikazu Boku

Organizations

Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan, Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan, Aichi Cancer Center Hospital, Nagoya, Japan, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan, Department of Medical Oncology, Tonan Hospital, Sapporo, Japan, Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan, Department of Medical Oncology, Keiyukai Sapporo Hospital, Sapporo, Japan, University of Tsukuba, Tsukuba, Japan, Department of Hematology/Oncology, Japan Community Health Care Organization Kyushu Hospital, Kitakyushu, Japan, Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan, Keiyukai Sapporo Hospital, Sapporo, Japan, Division of Gastroenterology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan, National Cancer Center Hospital, Tokyo, Japan

Research Funding

No funding received
None

Background: BBP has been recognized as one of the standard 2nd-line treatment strategy for pts with mCRC based on the ML18147 trial. However, this trial excluded pts with disease progression < 3 months in the 1st-line BEV-containing chemotherapy. Methods: The subjects were mCRC pts who received the 2nd-line chemotherapy after experiencing disease progression < 100 days in the 1st-line BEV-containing chemotherapy between Apr 2010 and Dec 2016. This multi-institutional retrospective study compared the efficacy and safety between the 2nd-line chemotherapy with BEV (BBP) and without BEV (non-BBP), adjusting ECOG PS, WBC, ALP, number of metastatic sites, RAS status, and sidedness using Cox proportional hazard model. Results: 61 pts were evaluated. Patients' backgrounds were numerically different between BBP (n = 36) and non-BBP (n = 25), such as PS (0-1/2≤/unknown: 89/8/3 and 56/40/4%) and RASstatus (wild/mutant/unknown: 28/56/16 and 76/16/8%). There were no significant differences in age (median: 59 and 57), sex (male/female: 53/47 and 32/68%), tumor location (right/left: 44/56 and 40/60%), disease status (stage IV/recurrence: 67/33 and 84/16%), number of metastatic sites (1/2≤: 33/67 and 20/80%), the 1st-line regimens (oxaliplatin-based/irinotecan-based: 83/17 and 96/4%) between two arms. The 2nd-line chemotherapy regimens with EGFR antibody-containing/cytotoxic alone were 64/36% in non-BBP, respectively. The response rates were 5.9 and 8.7% in BBP and non-BBP. Median PFS were 3.7 and 2.8 months (HR 0.83, 95%CI 0.49-1.41, p = 0.486; adjusted HR 0.97, 95%CI 0.48-1.96, p = 0.932), respectively. The proportions of pts who received subsequent chemotherapy were 58 and 32% (p = 0.068). Median OS were 7.6 and 5.4 months (HR 0.70, 95%CI 0.41-1.19, p = 0.193; adjusted HR 0.65, 95%CI 0.34-1.25, p = 0.195). Common grade 3-4 adverse events (AEs) were neutropenia (11/24%) and anemia (3/16%), and other AEs were similar between two arms. Conclusions: The 2nd-line chemotherapy for pts with early progression in the 1st-line BEV-containing chemotherapy showed poor outcomes regardless of strategy.

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Abstract Details

Meeting

2020 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Anal and Colorectal Cancer

Track

Colorectal Cancer,Anal Cancer

Sub Track

Therapeutics

Citation

J Clin Oncol 38, 2020 (suppl 4; abstr 113)

Abstract #

113

Poster Bd #

E21

Abstract Disclosures