979P - Achievement of complete response (CR) in metastatic or recurrent cervical cancer (MRCC): Does it matter?

Date 09 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Cervical Cancer
Gynaecologic Malignancies
Presenter Juan Francisco Grau Béjar
Citation Annals of Oncology (2017) 28 (suppl_5): v330-v354. 10.1093/annonc/mdx372
Authors J.F. Grau Béjar1, V. Rodriguez Freixinos2, L. Fariñas Madrid2, G. Villacampa Javierre3, A. Gil-Moreno4, R. Verges5, M.A. Pérez Benavente4, A. García6, R. Dienstmann7, A. Oaknin1
  • 1Medical Oncology, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 2Oncología Médica, Hospital Vall d´Hebron, 08023 - Barcelona/ES
  • 3Biostatistics, Vall d'Hebron Institute of Oncology, 08035 - Barcelona/ES
  • 4Gynaecology, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 5Radiation Oncology, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 6Pathology, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 7Grupo De Oncology Data Science (odyssey), Vall d'Hebron Institute of Oncology, 08035 - Barcelona/ES

Abstract

Background

MRCC is a devastating disease with poor long-term outcomes. Bevacizumab (BEV) added to chemotherapy (CT) improves significantly overall survival (OS) in MRCC patients (pts). Aim: to characterize clinic-pathologic features associated to CR and its impact on pts outcome.

Methods

Single-institution chart review of MRCC pts who were treated with 1st line CT between 2005 and 2016. CR was defined by Response Evaluation Criteria in Solid Tumors (RECIST v1). The prognostic and predictive value of clinic-pathologic features, was evaluated.

Results

Seventy-two pts (62% squamous; 30% adenocarcinoma; 8% others); with median age of 48 years (28-77) were selected. Forty-five pts (62%) had prior CT-radiation; 55 pts (79%) had recurrent/persistent disease (27 pts > 12 months (m) disease free interval) and 15 pts (21%) were stage IVb (90% visceral involvement). Moore risk distribution: 7/44/21 pts were high/medium/low risk, respectively. Eleven pts (15%) received BEV + CT; 57 pts (79%) platinum-based-CT (PCT) (54% Cisplatin; 26% Carboplatin) and 4 (6%) non-PCT. After a median follow-up of 33 m, ORR 51%, median OS 13 m (9.5-NA) and median PFS 6 m (4.6 -7.7) were observed for overall population. Moore criteria correlated with prognosis (high-risk pts had significantly worse OS (HR = 0.04, p 0.2 all comparisons). Higher ORR was observed among low and intermediate risk pts (51%, 67%; p = 0.006). CRs occurred in 13/71 (18%) evaluable pts (BEV group 2/11; non-BEV 11/60, p = 1). Clinic-pathologic features, including Moore criteria, did not correlate with CR in univariate analysis. Median time to CR was 3.5 m (3 –NA) and median duration of CR was 7 m (4.3–NA). Five pts (7%) had CR in the irradiated field. CR significantly impacted on PFS (9.7 m vs 4.7 m non-CR, p = 0.002) and OS (31 m vs 9.5 m non-CR, p = 0.001). Eight pts discontinued treatment due to toxicity.

Conclusions

CR is a meaningful surrogate marker for improved PFS and OS in MRCC pts treated with 1st line CT, but no predictive features have been identified in our cohort. Moore prognostic score was validated in real-word practice but its capability guiding therapy needs further evaluation.

Clinical trial identification

Legal entity responsible for the study

Vall d´Hebron Institute of Oncology

Funding

None

Disclosure

A. Oaknin: Consulting or advisory role for PharmaMar, Clovis, Roche, AstraZeneca. All other authors have declared no conflicts of interest.