The tumour-stroma ratio (TSR) has proven to be an independent prognostic factor in colon cancer.
We evaluated the predictive potential of TSR on disease free survival (DFS) and overall survival (OS) in patients with high-risk stage II and stage III colon cancer who received standard oxaliplatin-based chemotherapy with or without bevacizumab.
Haematoxylin and Eosin stained tumour slides of 1212 patients (42% of intention-to-treat(ITT)) enrolled in the AVANT trial were microscopically scored for TSR and categorized as stroma-low or stroma-high.
TSR scores were correlated to the primary endpoint DFS and secondary endpoint OS.
Of 1212 tumour slides, 1163 could be scored for TSR. Patients with stroma-high tumours (n = 339) had a significant shorter DFS (p
Addition of bevacizumab to intravenous oxaliplatin-based chemotherapy suggests, in accordance with AVANT ITT analysis, a pronounced shorter DFS and OS in low stromal tumours. In contrast, in high stromal tumours a (potential) beneficial trend is observed when adding bevacizumab to intravenous oxaliplatin-based chemotherapy.
Clinical trial identification
Legal entity responsible for the study
H. Gelderblom: Investigational grant institution: Roche. C. Mancao: Employmee of Roche, Genentech stock and other ownership interests; patents, royalties, other intellectual property: Roche/Genentech. All other authors have declared no conflicts of interest.