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
540P - Phase III study of serplulimab plus chemotherapy as first-line therapy for advanced squamous non-small cell lung cancer: ASTRUM-004 Asian subgroup
Presenter: Caicun Zhou
Session: Poster Display
Resources:
Abstract
541P - Integrated analysis of randomized controlled trials IMpower130 and IMpower132 for advanced non-squamous non-small cell lung cancer (NSCLC)
Presenter: Hibiki Udagawa
Session: Poster Display
Resources:
Abstract
542P - First-line HLX07 plus serplulimab with or without chemotherapy versus serplulimab plus chemotherapy in advanced/recurrent squamous non-small cell lung cancer: A phase II study
Presenter: Zhen Wang
Session: Poster Display
Resources:
Abstract
543P - A multicenter retrospective study to investigate risk factors for immune checkpoint inhibitor-induced pneumonitis in non-small cell lung cancer patients with comorbid interstitial pneumonia
Presenter: Yuriko Ishida
Session: Poster Display
Resources:
Abstract
544P - Single cell level investigation of blood cells representing immune checkpoint inhibitor response in lung adenocarcinoma patients
Presenter: Juyong Seong
Session: Poster Display
Resources:
Abstract
545P - Completion of pembrolizumab in advanced non-small cell lung cancer: Real-world outcomes after two years of therapy (COPILOT)
Presenter: Andrew Fantoni
Session: Poster Display
Resources:
Abstract
546P - Combination therapy with anti-PD-1 antibody plus angiokinase inhibitor exerts synergistic antitumor effect against malignant mesothelioma via tumor microenvironment modulation
Presenter: Akio Tada
Session: Poster Display
Resources:
Abstract
547P - Immunotherapy outcome in advanced/metastatic lung cancer patients in real-world experience: Indian data
Presenter: Naveen K
Session: Poster Display
Resources:
Abstract
548P - B-Myb acts as a mentor instant promoter in non-small cell lung cancer by modifying the PD-1/PD-L1 axis
Presenter: Pan Xu
Session: Poster Display
Resources:
Abstract
549P - Drug-induced interstitial lung disease in patients with non-small cell lung cancer treated with immunotherapy for postoperative recurrence: Evaluation of CT findings and histopathological findings of the background lung
Presenter: shodai fujimoto
Session: Poster Display
Resources:
Abstract