P-0243 - Deep responders represent a group with excellent survival in patients with metastatic colorectal cancer (mCRC) treated with Triplet chemotherapy reg...

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Anti-Cancer Agents & Biologic Therapy
Colon Cancer
Rectal Cancer
Presenter Shouki Bazarbashi
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors S. Bazarbashi1, A. Al Jubran2, A. Al Zahrani1, H. Soudy1, M. Shoukri1
  • 1King Faisal Specialist Hospital and Research Center, Riyadh/SA
  • 2King Faisal Specialist Hospital and Research Center-King Faisal Cancer Center, Riyadh/SA



TCR with fluoropyrimidines, Oxaliplatin (O) and Irinotecan (I) have shown better efficacy in term of response and survival in mCRC. Depth of response represents the amount of shrinkage in the sum of tumor measurements according to RECIST criteria. We report here the excellent survival in the group of patients who achieved 40% or more reduction in their tumor measurment in the setting of phase II trial of the combination of capecitabine, O, I and Bevacizumab (B).


Eligible patients had locally advanced or mCRC. Patients received 5-8 cycles of the combination of C: 1000 mg/m2 bid Days1-14, O: 130 mg/m2 IV day 1, I: 150 mg/m2 IV day1 and B: 7.5 mg/kg body weight IV day1. Cycles repeated every 21 days. Patients with response or stable disease were then maintained on the combination of C and B till progression. Radiological assessment for response was done after 2nd, 5th and 8th cycles and the every 3 cycles. Tumor measurement according to RECIST criteria at each CT scan was recorded for all patients.


54 patients enrolled. Median age 52 years (range 23-74). 28 (52%) were males. Performance status 0/1/2 were 11.3%/66%/19%. 9.4% received prior adjuvant chemotherapy. 54.7% had multi-organ involvement. Median follow up was 23 months. 45 patients evaluable for response. Response evaluation: CR: 4.4%, PR: 60%, SD 31% for a disease control rate of 95.4%. Median time to best response was 48 days (range 18-1041). Seven patients (15.5%) had tumor shrinkage more or equal to 40%, none of the progressed (progression free survival PFS 100%). Patients with less than 40% tumor shrinkage had PFS of 10.5 months (95%CI), P value less than 0.0001.


Patients with locally advanced unresectable or mCRC treated with TCR, have improved PFS. Those who achieve tumor shrinkage equal or more than 40% represent a subgroup with the greatest benefit. Molecular studies should be done to identify this group of patients earlier.