534P - Raltitrexed in the management of metastatic colorectal cancer: The COMET study

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Colon Cancer
Rectal Cancer
Presenter Jerome Desrame
Citation Annals of Oncology (2014) 25 (suppl_4): iv167-iv209. 10.1093/annonc/mdu333
Authors J. Desrame1, L.M. Dourthe2, P. Debourdeau3, D. Mille4, H. Albrand5
  • 1Hôpital Privé Jean Mermoz, Institut privé de cancérologie, 69373 - Lyon/FR
  • 2Oncologie Medicale, Clinique Sainte Anne, 67000 - Strasbourg/FR
  • 3Oncology, Institut Sainte Catherine, 84918 - Avignon/FR
  • 4Oncologie, Médipole de Savoie, 731900 - Challes-les-Eaux/FR
  • 5Medical Director, Laboratoire HOSPIRA France, 92360 - Meudon La Forêt/FR

Abstract

Aim

Fluoropyrimidines are the backbone of many chemotherapy regimens for colorectal cancer (CRC). Such treatments can lead to cardiotoxicity and are inappropriate for patients with cardiovascular (CV) risk factors or prior cardiovascular disease (CVD). Raltitrexed, indicated for palliative treatment of advanced CRC, may be a useful option for these patients. COMET was a non-interventional study conducted in France to describe the characteristics of patients with metastatic CRC (mCRC) treated with raltitrexed, with emphasis on CV risk factors and prior CVD.

Methods

Patients (≥18 years) with mCRC, treated with raltitrexed as a single agent or in combination therapy were included. Patient and cancer characteristics were recorded at baseline along with CV risk factors and CVD history. Data were collected during a single visit, based on patient medical files. Data prior to inclusion were recorded retrospectively.

Results

414 patients (62.8% male; mean age 69.8 ± 10.1 years; WHO performance status ≤1: 72.4%) were analysed. At inclusion, all patients had mCRC; most common metastases were liver (75.4%) and lung (43.7%). 80.1% of patients had CV risk factors (arterial hypertension: 57.0%; diabetes: 12.8%) and 35.2% had prior CVD (creatinine clearance <60mL/min: 14.7%; angina: 11.8%; myocardial infarction: 11.8%). Overall, 84.8% had received ≥1 prior chemotherapy (metastatic: 54.8%; adjuvant: 6.0%; both: 23.9%) and 79.5% had received 5FU-based chemotherapy. During the last course of chemotherapy prior to switching to raltitrexed, 87.1% of patients experienced ≥ grade 1 toxicity; main toxicities experienced were digestive (46.6%) and cutaneous/mucosal (40.8%). Reasons for switching to raltitrexed were prior treatment failure (49.8%), short 15-min infusion duration (34.8%), CV risk (17.6%), prior CVD (16.2%) and 5FU associated toxicities (15.2%). 57.2% of patients received raltitrexed as combination therapy (oxaliplatin: 65.0%; bevacizumab: 30.0%). Mean initial dosage of raltitrexed was 2.6 ± 0.6 mg/m2. 89.1% of patients with prior acute CV events had no cardiac toxicity during treatment with raltitrexed.

Conclusions

Raltitrexed is a safe therapeutic alternative to 5FU for mCRC patients with prior CVD/CV risk factors.

Disclosure

J. Desrame: I have been a consultant for Roche and Sanofi; L.M. Dourthe: I have been a board member for Roche and Sanofi and a consultant for Merck Serono and Amgen; P. Debourdeau: I have been a board member for Daiichi Sanyko and Pfizer; H. Albrand: I am an employee of Hospira France SAS. All other authors have declared no conflicts of interest.