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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

3106 - Determinants of oncologist’s choice in offering drug holidays during first line therapy for patients with metastatic colorectal cancer

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

Topics

Tumour Site

Colon and Rectal Cancer

Presenters

Silvio Ken Garattini

Citation

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

Authors

S.K.K. Garattini1, M. Bonotto1, L. Porcu2, E. Ongaro1, D. Basile3, F. Cortiula1, G. Pelizzari3, M. Cattaneo1, A. Parnofiello1, V.J. Andreotti1, C. Corvaja3, G.G. Cardellino1, P. Ermacora1, M. Casagrande1, D. Iacono1, N. Pella1, A. Buonadonna3, A.M. Minisini1, F. Puglisi3, G. Fasola1

Author affiliations

  • 1 Oncology, ASUIUD Azienda Ospedaliero-Universitaria di Udine, 33100 - udine/IT
  • 2 Laboratory Of Methodology For Clinical research-oncology, IRCCS Istituto di ricerche farmacologiche Mario Negri, 20156 - milano/IT
  • 3 Oncology, CRO di Aviano, 33081 - Aviano/IT
More

Resources

Abstract 3106

Background

Overall survival of patients (pts) with metastatic colorectal cancer (mCRC) has been increasing over the last decades. “Drug holiday” strategies were introduced by the oncologists to reduce toxicity. We aimed at studying what are the clinico-pathological and treatment factors that drive the decision to propose a “drug holiday” in first line.

Methods

This is a retrospective series of consecutive pts affected by mCRC treated with first line chemotherapy. The pts included were treated from 1/1/2005 to 15/03/2017 at University Hospital of Udine and IRCCS CRO of Aviano, Italy. A “drug Holiday” was defined as 56 or more consecutive days without chemotherapy during first-line. Upfront metastasectomy were excluded. Logistic regression was used to find association between predictors and “holiday offer” in univariate and multivariate analysis.

Results

A total of 648 pts were included. In detail, 215 received a drug holiday (33.2%) while 433 (66.8%) received continuous treatment. In univariate analysis, the variables associated with holiday were: non-upfront metastasectomy (OR 11.8, IC 95% 6.62-22.6, p < 0.001), thermoablation (OR 6.08, IC 95% 3.19-11.58, p < 0.001), primary tumor (OR 2.79, IC 95% 1.79-4.34, p < 0.001), G3-G4 pathological grade (OR 1.49, IC 95% 1.01-2.19, p = 0.046), adjuvant CT (OR 1.54,IC 95% 1.06-2.33, p = 0.023). Adjuvant RT (OR 1.62, IC 95% 0.99-2.62, p = 0.051) showed a trend towards association. More than one metastatic site at diagnosis (OR 0.59, IC 95% 0.42-0.83, p = 0.003) and nodal involvement (OR 0.57, IC 95%, 0.34-0.95, p = 0.032) were associated to continuous treatment. In multivariate analysis, only first line non-upfront metastasectomy (OR 9.89, IC95% 4.38-22.33, p < 0.001), thermoablation (OR 4.48, IC95% 1.97-10.19, p < 0.001) and primary tumor resection (OR 2.43, IC95% 1.14-5.19, p = 0.022) were independently associated with drug-holiday.

Conclusions

In our cohort, clinicians were more prone to propose a drug holiday in pts who had received non-upfront metastasectomy or thermo-ablation or were treated on their primary tumor. Having more than one site of metastasis at the beginning of 1st line and nodal involvement favored continuous therapy.

Clinical trial identification

Legal entity responsible for the study

ASUIUD- Azienda Ospedaliero-Universitaria di Udine, Dipertimento di Oncologia.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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