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Poster display session

2997 - Benefits of Upfront Primary Tumour Resection (UPTR) according to sidedness in mCRC: Retrospective analyses of TTD MACRO-2 and PLANET randomised Trials

Date

09 Sep 2017

Session

Poster display session

Presenters

Manuel Benavides

Citation

Annals of Oncology (2017) 28 (suppl_5): v158-v208. 10.1093/annonc/mdx393

Authors

M. Benavides1, A. Abad2, A. Carrato3, C. Gravalos4, A. Fernández-Montes5, E. Falcó6, E. González-Flores7, T. Garcia Garcia8, J.I. Martin-Valades9, J. Gallego Plazas10, M. Valladares-Ayerbes11, C. García-Girón12, R. Dueñas13, A. García-Tapiador14, C. Pericay15, F. Losa16, A. Viudez17, P. García-Teijido18, E. Diaz Rubio19, E. Aranda Aguilar20

Author affiliations

  • 1 Medical Oncology, Hospital Universitario Regional y Virgen de la Victoria, 29010 - Malaga/ES
  • 2 Medical Oncology, Catalan Institute of Oncology (ICO Badalona), Hospital Germans Trias i Pujol, 8916 - Badalona/ES
  • 3 Medical Oncology, Hospital Universitario Ramon y Cajal, IRYCIS CIBERONC, 28031 - Madrid/ES
  • 4 Medical Oncology, University Hospital 12 De Octubre, 28041 - Madrid/ES
  • 5 Medical Oncology, Complejo Hospitalario Universitario de Ourense, Orense/ES
  • 6 Medical Oncology, Hospital Son Llatzer, Palma de Mallorca/ES
  • 7 Medical Oncology, Hospital Virgen de las Nieves, Granada/ES
  • 8 Hematology And Medical Oncology, Hospital Universitario Morales Meseguer, 30008 - Murcia/ES
  • 9 Medical Oncology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid/ES
  • 10 Medical Oncology, Hospital General Universitario de Elche, 3203 - Elche/ES
  • 11 Medical Oncology, Hospital Universitario a Coruna - a Corunac, 15006 - A Coruna/ES
  • 12 Medical Oncology, Hospital Universitario de Burgos, Burgos/ES
  • 13 Medical Oncology, Complejo Hospitalario De Jaén, Jaén/ES
  • 14 Medical Oncology, Complejo Hospitalario la Mancha Centro, Ciudad Real/ES
  • 15 Medical Oncology, Hospital de Sabadell Corporacis Parc Tauli, 8208 - Sabadell/ES
  • 16 Medical Oncology, Hospital de Sant Joan Despí - Moisés Broggi, Hospitalet/ES
  • 17 Medical Oncology, Complejo hospitalario de Navarra, 31008 - Pamplona/ES
  • 18 Medical Oncology, Hospital San Agustín, Avilés/ES
  • 19 Medical Oncology, Hospital Clinico Universitario San Carlos. CIBERONC Instituto de Salud Carlos III, 28040 - Madrid/ES
  • 20 Medical Oncology, IMIBIC. University Hospital Reina Sofia. CIBERONC Instituto de Salud Carlos III, 14004 - Cordoba/ES
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Resources

Abstract 2997

Background

UPTR remains controversial in the initial management of unresectable asymptomatic mCRC patients (pts), whereas right sidedness is a bad prognostic factor.

Methods

Retrospective pooled analysis of KRAS WT mCRC pts treated with 1st line EGFR inhibitors (EGFRI) + chemotherapy (CT) from two phase II randomised trials (MACRO-2 & PLANET). We analysed UPTR effect on overall survival (OS) and progression free survival (PFS) by tumour sidedness (right/left) and stage (I-III/IV) at diagnosis. All stage I-III pts underwent UPTR at diagnosis as standard procedure.

Results

260 pts were included in the analysis (Table). In pts with stage IV at diagnosis, UPTR was associated with a better OS, although differences were only significant in right sided tumours (mOS (m): 20.9 vs 10.6; HR non-UPTR vs UPTR 2.1 (1.0, 4.3); P = 0.038). Conversely, left sided tumours had a significantly better OS vs right sided tumours regardless of UPTR: UPTR HR 0.4 (0.2, 0.8); P = 0.006; no UPTR HR 0.2 (0.1, 0.4); P 

Conclusions

In mCRC KRAS WT pts treated in 1st line with EGFRI + CT, UPTR seemed to improve outcomes particularly in right sided tumours. Table: 492P Median (95%CI) OS and PFSTable:

492P

RightLeft
UPTRNo UPTRUPTRNo UPTR
Stage I-III at diagnosis, N931
OS(m)34.928.9
(30.6 -)(17.6 -)
HR left vs right1.5 (0.6, 4.1)
p0.430
PFS(m)14.310.8
(8.5, 19.8)(7.6, 13.9)
HR left vs right1.7 (0.7, 4.2)
p0.281
Stage IV at diagnosis, N182478100
OS(m)20.910.636.926.5
(5.9, 34.2)(6.3, 11.8)(25.3, 45.8)(20.7, 32.0)
HR No UPTR vs UPTR2.1 (1.0, 4.3)1.4 (1.0, 2.0)
p0.0380.088
UPTR
HR left vs right0.4 (0. 2, 0.8)
p0.006
HR Stage IV vs Stage I-III4.4 (1.4, 13.9)1.0 (0.6, 1.8)
p0.0190.931
No-UPTR
HR left vs right0.2 (0.1, 0.4)
p

Clinical trial identification

MACRO-2 trial: NCT01161316 - PLANET trial: NCT00885885

Legal entity responsible for the study

Spanish Cooperative Group for the Treatment of Digestive Tumors (TTD)

Funding

Amgen S.A. (PLANET) and Merck. S. L. (MACRO-2)

Disclosure

M. Valladares-Ayerbes: Consultant or advisory relationship and honoraria: Roche, Amgen, Merck Serono. A. García-Tapiador: Consultant or advisory role and honoraria: Merck. E. Aranda Aguilar: Advisory role from Amgen, Bayer, Celgene, Merck, Roche, Sanofi. All other authors have declared no conflicts of interest.

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