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.
Resources from the same session
1310 - Lymphocytes express receptor tyrosine kinases in patients with renal cell carcinoma and healthy donors
Presenter: Ilya Tsimafeyeu
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
Resources:
Abstract
1596 - Oncogenes analysis using GO-based clustering
Presenter: Dmitriy Babenko
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
Resources:
Abstract
5181 - PNU-74654 enhances the antiproliferative effects of 5-FU in breast cancer and antagonizes thrombin induced cell growth via the Wnt Pathway
Presenter: Soodabeh Shahid Sales
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
Resources:
Abstract
3344 - P21 has the potential to become the monitoring marker for the CDK4/6 inhibitors resistance in breast cancer
Presenter: Masafumi Iida
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
Resources:
Abstract
894 - Overexpression of NAMPT in adult T-cell leukemia/lymphoma patients and anti-tumor activity of a NAMPT inhibitor in vivo
Presenter: Tomohiro Kozako
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
Resources:
Abstract
2224 - 9-ING-41, a clinically relevant inhibitor of Glycogen Synthase Kinase-3 (GSK-3), is active pre-clinically in human bladder and renal cell cancers
Presenter: Hiroo Kuroki
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
Resources:
Abstract
3380 - A new natural compound identified with metabolomic approach has cytotoxic activity against human colorectal cancer cell lines with acquired resistance to cetuximab
Presenter: Vincenzo De Falco
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
Resources:
Abstract
4713 - Multiple Myeloma Metal Levels and Proteasome Activity
Presenter: Kai Uwe Stumpf
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
Resources:
Abstract
4134 - A translational drug-screening tool for interrogating the effect of anti-TGF-_ therapy on fibroblast activity and the desmoplastic reaction
Presenter: Neel Nissen
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
Resources:
Abstract
2736 - Eribulin demonstrate selectively high sensitivity to recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC) cells and xenograft tumors
Presenter: hiroko kitahara
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
Resources:
Abstract