Abstract 117P
Background
First-line (1L) treatment options for LS RASwt mCRC include the addition of epidermal growth factor receptor inhibitors (EGFRi) to chemotherapy (CT), supported by the overall survival advantage versus CT + bevacizumab (BEV) demonstrated recently in PARADIGM, the first phase 3 trial with pre-planned analysis by tumour side. Treatment selection and outcomes in Australasian routine practice has yet to be described.
Methods
Data from 1/2015 – 5/2023 on patients with LS RASwt mCRC who received 1L doublet CT for palliative intent was reviewed from TRACC, a prospective, multi-site Australasian registry. Baseline clinicopathological characteristics and survival outcomes were analysed with p ≤0.05 denoted as statistical significance.
Results
Of 676 LS RASwt, palliative intent, mCRC patients, 573 (85%) were actively treated, 404 (60%) receiving 1L doublet CT. Of these, 193 (48%) also received EGFRi and 120 (30%) also received BEV. Compared to BEV, patients receiving 1L EGFRi trended towards younger age (57 vs 61 years, p=0.07), were more often Stage IV at diagnosis (80% vs 70%, p=0.05), and less likely to have a BRAF mutant tumour (5% vs 17%, p=0.002). Median progression-free survival (PFS) was 11.7, 9.7 and 10.9 months for EGFRi + doublet CT, BEV + doublet CT and doublet CT alone respectively (HR 0.86 [0.67-1.12], p=0.06 for EGFRi + doublet CT versus BEV + doublet CT). Median overall survival (OS) was 38.1, 29.8 and 31.0 months for EGFRi + doublet CT, BEV + doublet CT and doublet CT alone respectively (HR 0.78 [0.58-1.07], p=0.12 for EGFRi + doublet CT versus BEV). Second-line (2L) PFS was similar for initial EGFRi (n=50 patients) then BEV versus opposite (n=32 patients) sequence (9.7 vs 8.0 months, p=0.55). Notably 24% of patients did not receive an EGFRi in 1L or 2L.
Conclusions
In Australasian practice, 1 in 2 patients with LS RASwt mCRC received 1L treatment with EGFRi + doublet CT, with trends toward improved PFS and OS versus BEV + doublet CT. 1 in 4 patients never received an EGFRi in 1L or 2L treatment, with further research required to understand clinician rationale for reserving active targeted treatments to later line settings.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
WEHI.
Funding
Merck.
Disclosure
V. Wong, B.B.Y. Ma: Financial Interests, Institutional, Research Funding: Merck Serono. All other authors have declared no conflicts of interest.
Resources from the same session
154P - Adverse events (AEs) as potential predictive factors of activity in patients with advanced hepatocellular carcinoma (HCC) treated with atezolizumab plus bevacizumab (AB)
Presenter: Mara Persano
Session: Poster Display
Resources:
Abstract
155P - Penpulimab combined with anlotinib and nab-paclitaxel plus gemcitabine (PAAG) as first-line treatment for advanced metastatic pancreatic cancer: A prospective, multicenter, single-arm, phase II study
Presenter: Juan Du
Session: Poster Display
Resources:
Abstract
156P - Phase II trial of second-line regorafenib in patients with unresectable hepatocellular carcinoma after progression on first-line atezolizumab plus bevacizumab: REGONEXT trial
Presenter: Jaekyung Cheon
Session: Poster Display
Resources:
Abstract
157P - T/N ratio and radiation dose delivered do not correlate with the development of Radioembolization-Induced Liver Disease (REILD) in Hepatocellular Carcinoma (HCC) following Y90 selective internal radiation therapy (Y90-SIRT): A retrospective, single tertiary centre cohort study
Presenter: Daniel Yang Yao Peh
Session: Poster Display
Resources:
Abstract
158P - Single-cell RNA sequencing via Endoscopic Ultrasoundguided Fine-Needle Biopsy (EUS-FNB) Pancreatic Biopsies uncovered an aggressive subclone with a poor prognosis
Presenter: Yung-yeh Su
Session: Poster Display
Resources:
Abstract
159P - Classical computer vision and modern deep-learning of pancreatic stroma histology features to diagnose cancer
Presenter: Abdelhakim Khellaf
Session: Poster Display
Resources:
Abstract
160P - Interim analysis of the NAPOLEON-2 study: Safety evaluation of nano-liposomal irinotecan with fluorouracil and folinic acid for advanced pancreatic cancer
Presenter: Wataru Kusano
Session: Poster Display
Resources:
Abstract
161P - Screening and COnsensus based on Practices and Evidence (SCOPE): Real-world survey on Japanese and rest-of-world practice patterns in resectable pancreatic cancer
Presenter: Elizabeth Smyth
Session: Poster Display
Resources:
Abstract
162P - Recurrence pattern of hepatocellular carcinoma patients receiving curative surgery of RFA: An update
Presenter: Long Chan
Session: Poster Display
Resources:
Abstract
163P - Chemotherapy versus palliative radiotherapy in advanced inoperable gall bladder cancer
Presenter: Vimal Sekar
Session: Poster Display
Resources:
Abstract