629 - Different clinical outcome of metastatic colorectal cancer (mCRC) patients treated with intensive triplet chemotherapy plus bevacizumab (FIR-B/FOX)...

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anti-Cancer Agents & Biologic Therapy
Colon Cancer
Rectal Cancer
Translational Research
Presenter Gemma Bruera
Authors G. Bruera1, K. Cannita2, D. Di Giacomo3, A. Lamy4, A. Dal Mas5, T. Frebourg6, J.C. Sabourin7, M. Tosi6, C. Ficorella2, E. Ricevuto2
  • 1S. Salvatore Hospital, University of L'Aquila, 67100 - L'Aquila/IT
  • 2Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 - L'Aquila/IT
  • 3Department Of Experimental Medicine, University of L’Aquila, 67100 - L'Aquila/IT
  • 4Laboratory Of Tumor Genetics, University Hospital, Rouen, Rouen/FR
  • 5Pathology, S. Salvatore Hospital, 67100 - L'Aquila/IT
  • 6Inserm U614, University of Rouen, Rouen/FR
  • 7Department Of Pathology, Inserm U614, Rouen University Hospital, Rouen/FR

Abstract

Background

Bevacizumab (BEV) plus triplet chemotherapy can increase efficacy of first-line treatment of MCRC (Bruera G et al, BMC Cancer 2010, 10:567), particularly if integrated with secondary liver surgery in liver-limited (L-L) patients (pts) (Bruera G et al, Clin Colorectal Cancer 2012). Clinical outcome of FIr-B/FOx regimen was evaluated according to KRAS genotype in L-L and other MCRC pts.

Methods

Tumoral and metastatic samples were screened for KRAS codon 12 and 13, and BRAF mutations by SNaPshot and/or direct sequencing. MCRC pts were classified as L-L and other or multiple metastatic (O/MM). Activity and efficacy were evaluated and compared using log-rank test.

Results

Fifty-nine pts were evaluated: 31 KRAS wild-type, 53%; 28 KRAS mutant, 47%. At 21.5 months median follow-up, objective response rate (ORR), progression-free survival (PFS) and overall survival (OS) were, respectively: KRAS wild-type 90%, 14 months, 38 months; KRAS mutant 67%, 11 months, 20 months. PFS and OS were, respectively: overall in 25 L-L compared to 32 O/MM evaluable pts, 17 and 12 months, 47 and 21 months, significantly different; in KRAS wild-type, 12 L-L compared to 18 O/MM, 21 and 12 months, 47 and 28 months, significantly different; in KRAS mutant, 13 L-L compared to 14 O/MMS, 11 months equivalently, 39 and 19 months, not significantly different.

Conclusion

First line FIr-B/FOx regimen can increase activity and efficacy of KRAS wild-type and mutant MCRC pts; integration with secondary liver surgery significantly discriminates increased clinical outcome in KRAS wild-type L-L compared to O/MM pts while not in KRAS mutant pts.

Disclosure

All authors have declared no conflicts of interest.