624 - Pathological response of synchronous liver metastases from colorectal cancer treated with bevacizumab plus MFOLFOX6 in an analysis of a phase II stu...

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anti-Cancer Agents & Biologic Therapy
Colon Cancer
Rectal Cancer
Pathology/Molecular Biology
Presenter Yu Katayose
Authors Y. Katayose1, J. Yamauchi2, M. Oikawa3, N. Sakurai4, H. Musya5, H. Shimamura6, K. Miura7, K. Nakagawa8, S. Egawa7, M. Unno7
  • 1Integrated Surgery And Oncology, Tohoku University Graduate School of Medicine, Sendai/JP
  • 2Surgery, Sendai Kosei Hospital, Sendai/JP
  • 3Surgery, Sendi city medical center, Sendai/JP
  • 4Surgery, Yamagata central hospital, Yamagata/JP
  • 5Surgery, Tohoku Rosai Hospital, Sendai/JP
  • 6Surgery, Sendai Medical Center, Sendai/JP
  • 7Surgery, Tohoku University Graduate School of Medicine, Sendai/JP
  • 8Intergrated Surgery And Oncology, Tohoku University Graduate School of Medicine, Sendai/JP

Abstract

Background

The prognosis of synchronous liver metastases (SLM) from colorectal cancer is poor. Therefore, we, the Miyagi Hepato-biliary pancreatic clinical oncology group (Miyagi-HBPCOG), conducted a phase II study of neoadjuvant chemotherapy for SLM to determine the appropriate initial treatment. Here, we assessed the radiologic and pathological responses.

Patients and methods

Patients were enrolled after R0-resection of the primary colorectal cancer and received 8 courses of mFOLFOX6 with bevacizumab (the first and last courses were mFOLFOX6 alone). The main inclusion criteria were SLM within 10 nodules, histologically confirmed, measurable disease. The primary endpoint was the response rate (RR).

Result

Between June 2008, and November 2008, 47 patients were enrolled from 17 centers. The median age was 62 years (range 32-72 yrs). The median number of metastases was 2 nodules, and the maximum diameter of tumors was 12.9 cm. Three patients were excluded from the evaluation of RR because they did not receive any scheduled chemotherapy. The overall RR was 70.5% (2 complete responses and 29 partial responses). Eleven patients (25%) showed stable disease and 1 patient (2.3%) had progressive disease. The liver resections rate was 90.9% (40/44) and the R0-resection rate was 86.3% (38/44). The pathological response was evaluated tumor regression grade (TRG1-5). Major response (TRG1 and 2) was 55%, partial response (TRG2) was 32.5%, and no response (TRG4 an 5) was 12.5%. This major response rate was high, so the progression-free survival and overall survival can be extended is expected. Necrosis was also graded as 1 to 4. Major necrosis of Grade 3 and 4 was 52.5%, and Grade 2 was 17.5%, and Grades 0 and 1 of no necrosis were 30.0%. Although the necrosis rate slightly correlated with the pathological response, the radiological response did not correlate with it.

Conclusion

Pathological and radiological response of liver metastases treated with bevacizumab plus mFOLFOX6 appeared favorable. Therefore, the progression-free survival and overall survival could be expected to be extended. (Trials Registry: UMIN000001568).

Disclosure

All authors have declared no conflicts of interest.