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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

2453 - In the pathway to response: Is aflibercept an optimal treatment for RASwt mCRC patients after progression to 1st line containing anti-EGFR?

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Presenters

Elena Mata Velasco

Citation

Annals of Oncology (2018) 29 (suppl_8): viii150-viii204. 10.1093/annonc/mdy281

Authors

E. Mata Velasco1, E. González-Flores2, I. Juez Martel3, V. Alonso4, P. Iranzo Gomez5, N. Martinez Lago6, C. Lopez7, J.M. Cabrera Romero8, M.J. Safont Aguilera9, A. Ruiz Casado10, M. Salgado Fernandez11, B. González Astorga12, P. Escudero5, F. Rivera Herrero13, C. Pericay Pijaume14, R. Vera1

Author affiliations

  • 1 Medical Oncology, Complejo Hospitalario de Navarra, 31008 - Pamplona/ES
  • 2 Medical Oncology, Hospital Universitario Virgen de las Nieves, 18014 - Granada/ES
  • 3 Medical Oncology, Hospital Universitario de Fuenlabrada, Madrid/ES
  • 4 Medical Oncology Service, Hospital Miguel Servet, 50009 - Zaragoza/ES
  • 5 Medical Oncology, Hospital Clinico Universitario Lozano Blesa, 50009 - Zaragoza/ES
  • 6 Medical Oncology, Hospital Universitario a Coruna, 15006 - A Coruna/ES
  • 7 Medical Oncology, Marques de Valdecilla University Hospital, Santander/ES
  • 8 Medical Oncology, Hospital de Sabadell Corporacis Parc Tauli, 8208 - Sabadell/ES
  • 9 Medical Oncology, Hospital General Universitario Valencia, 46018 - Valencia/ES
  • 10 Medical Oncology, Hospital Puerta de Hierro, 28222 - Majadahonda/ES
  • 11 Medical Oncology, Complejo Hospitalario De Ourense, 32005 - Ourense/ES
  • 12 Medical Oncology, Hospital Universitario San Cecilio, Granada/ES
  • 13 Medical Oncology, Hospital Universitario Marques de Valdecilla, 39008 - Santander/ES
  • 14 Medical Oncology, Hospital de Sabadell Corporacis Parc Tauli, 08208 - Sabadell/ES
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Resources

Abstract 2453

Background

VELOUR trial compared FOLFIRI+/-aflibercept in 1226 mCRC patients after progression to oxaliplatin-based treatment, regardless of biological previous therapies. mOS (13.50 vs 12.06 months) and mPFS (6.90 vs 4.67 months) were increased, which led to aflibercept approval. We do not have yet enough information on aflibercept after anti-EGFR treatment. Our goal was to analyze efficacy and safety data of aflibercept in this specific context.

Methods

Retrospective analysis of clinical, therapeutic, and survival data collected from 120 consecutive RASwt mCRC patients treated from 2012 to 2017 with FOLFIRI-aflibercept after progression to standard chemotherapy + anti-EGFR in 12 Spanish hospitals.

Results

Median age was 60, 62.5% male, 37.5% female. 24% were right-sided tumours and 76% left-sided, with primary tumour resection in 41%. 100% RASwt, 5% BRAFmt. All patients received prior anti-EGFR therapy and 96% had ECOG 0/1. Median of FOLFIRI-Aflibercept cycles was 12, with 33% ORR. mPFS was 6.9 months (95% CI 6.0-7.7). BRAF, ECOG, primary tumour resection and nº of metastatic sites had statistical significance in univariate analysis; and primary tumour resection was also significant in multivariate analysis. mOS was 14.5 months (95% CI 9.7-19.3), with statistical significance in univariate for primary tumour resection, ECOG, and nº of metastatic sites. ECOG and nº of metastatic sites reached significance in multivariate analysis. As for toxicity, only 18.3% needed aflibercept dose reduction. 2nd line treatment was discontinued in 71.8% (mostly due to progression: 51.7%, 6.7% toxicity,1.7% surgery). 37% reached G3-4 toxicity (16.6% hematologic, 7.5% HTN, 5.9% asthenia, 2.5% perforation) 59% received a 3rd line therapy: 23% TAS-102, 18% regorafenib, 9% capecitabine.

Conclusions

RASwt mCRC patients reached similar results to those reported in VELOUR trial. The efficacy of subsequent aflibercept-containing 2nd line was maintained regardless of prior anti-EGFR. The efficacy of subsequent aflibercept-containing 2nd line was maintained regardless of prior anti-EGFR. Our results suggest that FOLFIRI-aflibercept, after 1st line with anti-EGFR, is a good treatment strategy for RASwt mCRC.

Clinical trial identification

Legal entity responsible for the study

Ruth Vera García.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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