Abstract 1976
Background
BRAF V600E-mutated colorectal liver metastases (CRLM) are associated with higher relapse rate and shorter survival time after resection as compared to BRAF wild-type CRLM. It remains unsure whether metastatic surgery has a benefit over chemotherapy alone in this setting. To address this question, we analyzed a large cohort of BRAF-mutated CRLM patients in order to evaluate the impact of liver surgery on overall survival (OS).
Methods
We retrospectively identified BRAF-mutated colorectal cancers diagnosed with liver-only metastases (n = 91) resected or not from October 1, 2003 to December 31,2017 in 24 French centers. The impact of CRLM resection on OS (primary endpoint) was analyzed by Kaplan-Meier method and Cox model. OS was defined from the time of CRLM diagnosis to death from any cause. Progression free survival (PFS) was defined from the time of first chemotherapy (even for resected patients) to first progression or death.
Results
Ninety-one patients were included: 43 (47%) with resected CRLM and 48 (53%) treated with chemotherapy only. Among resected CRLM, 34 (79%) received chemotherapy before surgery. BRAF V600E mutation was detected in 83 (91%) patients and non-V600E mutation in 8 (9%) patients. In comparison to resected CRLM, unresected CRLM were more often bilobar (76% versus 51%, p = 0.03) and greater than 5 (62% versus 34%, p = 0.02). There was no statistical difference in the other criteria especially in rates of synchronous metastases (94% versus 81%, p = 0.11). Median OS was 32.1 months for resected patients and 11.4 months for unresected patients (p < 0.0001). In univariate analysis, 4 parameters were statistically associated with poor OS: rectum primary site (p = 0.002), greater than 5 (p = 0.018), BRAF V600E mutation (p = 0.010) and no liver surgery (p < 0.0001). In multivariate analysis, liver surgery was the only variable associated with significant longer OS (hazard ratio [HR]= 0.125, CI 95%: 0.068 – 0.229, p < 0.0001) and PFS (HR = 0.173, CI 95% 0.101 – 0.296, p < 0.0001).
Conclusions
To our knowledge, this is the largest cohort of colorectal cancer with liver-only metastases harboring BRAF V600E mutation. Liver surgery extend significantly OS and therefore CRLM resectability should be assessed in BRAF-mutated colorectal cancer.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Ploquin, Anne.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3330 - Tumour-infiltrating lymphocytes and BRCA-like status in stage III breast cancer patients treated with intensified carboplatin-based chemotherapy
Presenter: Leonora De Boo
Session: Poster Display session 2
Resources:
Abstract
3971 - Unravelling the biological characteristics of MammaPrint extreme risk subgroups
Presenter: Rajith Bhaskaran
Session: Poster Display session 2
Resources:
Abstract
5871 - Residual Cancer burden as a prognostic factor in a large series of Neoadjuvant chemotherapy. Subgroup analysis per molecular surrogated subtypes
Presenter: Catalina Falo
Session: Poster Display session 2
Resources:
Abstract
5014 - Clinical validation of CanAssist Breast in a Spanish cohort
Presenter: Manjiri Bakre
Session: Poster Display session 2
Resources:
Abstract
2787 - Meta-analysis on association of pathological complete response with long-term survival outcomes in triple-negative breast cancer
Presenter: Peter A. Fasching
Session: Poster Display session 2
Resources:
Abstract
4301 - Immune infiltrate composition across intrinsic subtypes in hormone receptor (HR)+/HER2- early breast cancer (BC) enrolled in the prospective LETLOB trial
Presenter: Gaia Griguolo
Session: Poster Display session 2
Resources:
Abstract
3205 - Frequency of germline mutations in women's cancer susceptibility genes in a large cohort of Chinese breast cancer patients
Presenter: Ning Liao
Session: Poster Display session 2
Resources:
Abstract
4091 - Triple blinded Prospective Study assessing the Impact of Genomics & Artificial Intelligence Watson For Oncology (WFO) on MDT’s Decision of Adjuvant Systemic Therapy for Hormone Receptor Positive Early Breast Carcinoma-
Presenter: Somashekhar Sampige Prasannakumar
Session: Poster Display session 2
Resources:
Abstract
4359 - Prognostic significance of Progesterone Receptor levels in luminal-like Her2- early Breast Cancer patients. A retrospective single Cancer Center analysis.
Presenter: Anna Diana
Session: Poster Display session 2
Resources:
Abstract
1369 - PAM50 HER2-enriched subtype and pathological complete response in HER2-positive early breast cancer: a meta-analysis
Presenter: Francesco Schettini
Session: Poster Display session 2
Resources:
Abstract