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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


09 Sep 2017


Poster display session


Surgical Oncology;  Radiation Oncology;  Colon and Rectal Cancer


Manuel Benavides


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


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


Abstract 2997


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


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.


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 


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:


Stage I-III at diagnosis, N931
(30.6 -)(17.6 -)
HR left vs right1.5 (0.6, 4.1)
(8.5, 19.8)(7.6, 13.9)
HR left vs right1.7 (0.7, 4.2)
Stage IV at diagnosis, N182478100
(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)
HR left vs right0.4 (0. 2, 0.8)
HR Stage IV vs Stage I-III4.4 (1.4, 13.9)1.0 (0.6, 1.8)
HR left vs right0.2 (0.1, 0.4)

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)


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


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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