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
426P - Characterization of a novel comprehensive genomic profiling test with better detection of heterozygous deletions and gene fusions
Presenter: ryouta kakuta
Session: Poster Display
Resources:
Abstract
427P - Real-world performance of a comprehensive next-generation sequencing (NGS) panel for patients (pts) with solid tumors from Asia and the Middle East (AME)
Presenter: Nitesh Rohatgi
Session: Poster Display
Resources:
Abstract
428P - What do women want to see in a personalized breast cancer risk report? A qualitative study of Asian women of two countries
Presenter: Faustina Audrey Agatha
Session: Poster Display
Resources:
Abstract
429P - Clinical utility and outcomes of liquid biopsy-based next generation sequencing in identification of actionable genomic mutations in solid malignancy: A single center retrospective study in the Philippines
Presenter: Omar Maaño
Session: Poster Display
Resources:
Abstract
436P - Chemotherapy-induced hand-foot syndrome, comparative efficacy and safety of pharmacological prophylaxis: Systematic review and network meta-analysis
Presenter: Anand Srinivasan
Session: Poster Display
Resources:
Abstract
437P - A randomized single blinded phase II trial comparing efficacy and quality of life of topical aloe vera gel plus urea cream versus urea cream alone for prevention of hand-foot syndrome in cancer patients receiving capecitabine
Presenter: Lucksika Wanichtanom
Session: Poster Display
Resources:
Abstract
438P - A novel treatment for immune checkpoint inhibitor-related myocarditis
Presenter: Takahiro Niimura
Session: Poster Display
Resources:
Abstract
439P - Randomized controlled trial evaluating efficacy of topical urea-based cream for capecitabine-associated hand-foot syndrome prevention
Presenter: Concord Wongkraisri
Session: Poster Display
Resources:
Abstract
440P - Real-world adverse events of targeted therapy reported by pharmacist in oncology clinic
Presenter: TIKUMPORN PORNWISETSIRIKUL
Session: Poster Display
Resources:
Abstract
441P - The prophylactic efficacy of telpegfilgrastim, a Y-shape branched pegylated G-CSF in patient with chemotherapy-induced neutropenia: A multicenter, randomized phase III study
Presenter: Xinshuai Wang
Session: Poster Display
Resources:
Abstract