647 - Predictive markers for overall and progression-free survival with capox in second-line chemotherapy of metastatic colorectal cancer

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anti-Cancer Agents & Biologic Therapy
Colon Cancer
Rectal Cancer
Presenter María del Pilar Solís Hernández
Authors M.D.P. Solís Hernández1, P. Jimenez Fonseca2, Q. Perez3, C. Alvarez Fernandez4, L. Ruiz1, D. Rodriguez Rubi1, W. Li1, M.L. Sánchez1, L. Faez1, J.M. Viéitez1
  • 1Medical Oncology, Hospital Universitario Central de Asturias, 33006 - Oviedo/ES
  • 2Servicio De Oncologia Medica, Hospital Universitario Central de Asturias, 33006 - Oviedo/ES
  • 3Hospital Universitario Central de Asturias, 33006 - Oviedo/ES
  • 4Oncologia Medica, Hospital Universitario Central de Asturias, 33006 - Oviedo/ES

Abstract

Background

Age, sex, Karnofsky (KPS), number of metastatic sites (NMS), primary tumour localization, baseline CEA, CEA response, scan response and k-RAS status are focused on progression free survival (PFS) and overall survival (OS) as predictive factors in chemotherapy metastatic colorectal cancer (mCRC). This study aims to find which might generate impact on PFS and OS for a second line therapy.

Patients and methods

138 patients treated with capecitabine and oxaliplatin (CAPOX) in second-line from 2002 to 2010 were analyzed. Cox hazard model was employed to build univariante and multivariate analysis.

Results

PFS and OS were 3.5 and 7.85 months, respectively. Among all evaluated factors, only KPS ≥70, CEA response and scan response were associated with better PFS and OS on univariate analysis with statistical significance. Age <65 years and <2 metastatic sites were predictive only for OS. (See table 1) Multivariable analysis showed that scan response (HR = 0.34, p = 0.0003) and KPS ≥70% (HR = 0.96, p = 0.0002) were predictive for better PFS and OS (scan response: HR = 0.36, p = 0.0001 and KPS > 70%: HR = 0.97, p = 0.0007), while PTL (rectum, HR = 1.50, p = 0.032) and NMS (>2 sites, HR = 1.25, p = 0.0043) were predictive for worst PFS and OS, respectively. (See table 2) Table 1

– PFS and OS univariate analyses

N Median P-value
PFS KPS <0.001
<70% 43 2.3
≥70% 95 4.8
Response
Yes 23 6.8
No 115 2.9
CEA response
Yes 34 6.9
No 104 2.9
OS KPS <0.01
<70% 43 4.7
≥70% 95 11.9
Response
Yes 23 23.4
No 115 7.2
CEA response
Yes 34 13.6
No 104 7.8
Age
<65 68 11.7
≥65 70 6.7
NMS
≤ 2 78 9.9
> 2 60 6.8

Table 2 – PFS and OS multivariate analyses

P-value HR IC 95%
LIC HIC
PFS RECIST Response
<0.001 0.34 0.20 0.56
KPS ≥70
<0.001 0.96 0.95 0.98
Primary tumor localization Rectum
0.03 1.49 1.03 2.16
OS RECIST Response
<0.001 0.36 0.21 0.61
KPS ≥70 <0.001 0.97 0.96 0.98
Metastatic sites >2
0.004 1.25 1.07 1.46

Conclusion

These findings suggest that scan response and good KPS may predict better PFS and OS in mCRC while primary tumour localization, CEA response and NMS should be further validated.

Disclosure

All authors have declared no conflicts of interest.