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
184P - Neutropenia as a predictive and prognostic factor in nanoliposomal-irinotecan/fluorouracil/leucovorin therapy for pancreatic cancer: Findings from the NAPOLEON-2 study (NN-2301)
Presenter: Yuki Sonoda
Session: Poster Display
Resources:
Abstract
185P - Disease etiology impact on outcomes of hepatocellular carcinoma patients treated with atezolizumab plus bevacizumab: A real-world, multicenter study
Presenter: Silvia Foti
Session: Poster Display
Resources:
Abstract
186P - Efficacy and safety of fruquintinib with nab-paclitaxel in advanced G/GEJ cancer after exposure to immune checkpoint inhibitors: A single-center prospective clinical trial
Presenter: Xiaoting Ma
Session: Poster Display
Resources:
Abstract
187P - Neoadjuvant cadonilimab (PD-1/CTLA-4 bispecific antibody) plus transhepatic arterial infusion chemotherapy (HAIC) for resectable multinodular CNLC Ib/IIa hepatocellular carcinoma (Car-Hero)
Presenter: Yongguang Wei
Session: Poster Display
Resources:
Abstract
188P - Impact of metformin, statin, aspirin and insulin on the prognosis of unresectable HCC patients receiving first-line lenvatinib or atezolizumab plus bevacizumab
Presenter: Margherita Rimini
Session: Poster Display
Resources:
Abstract
189P - Safety run-in results from LEAP-014: First-line lenvatinib (len) plus pembrolizumab (pembro) and chemotherapy (chemo) for metastatic esophageal squamous cell carcinoma (ESCC)
Presenter: Shun Yamamoto
Session: Poster Display
Resources:
Abstract
190P - Perioperative camrelizumab combined with chemotherapy for locally advanced gastric or gastroesophageal junction adenocarcinoma: A single-arm, single-center, phase II clinical trial
Presenter: Jiaxing He
Session: Poster Display
Resources:
Abstract
191P - Predictive value of CXCR6 expression in gastric cancer survival and immune modulation
Presenter: Song-Hee han
Session: Poster Display
Resources:
Abstract
192P - Antiangiogenesis-related adverse events (ARAE) to predict efficacy in patients with advanced gastric cancer (AGC) treated with apatinib + chemotherapy: Results from two prospective studies
Presenter: Rongbo Lin
Session: Poster Display
Resources:
Abstract
193P - Impact of coronavirus disease 2019 on patients with unresectable hepatocellular carcinoma treated with atezolizumab/bevacizumab
Presenter: Hongjae Chon
Session: Poster Display
Resources:
Abstract