Abstract 5134
Background
Platinum-resistant relapse after 1st line treatment (platinum-free interval < 6 months) is a very detrimental event for patient survival. The modeled CA125 elimination parameter KELIM calculated during the first 100 chemotherapy days is a predictive factor of PFS/OS in 1st line treatment (Colomban et al. Clin Cancer Res 2019). KELIM was associated with the risk of subsequent platinum-resistant relapse (PtRR) in neoadjuvant setting (Robelin et al. Proc ASCO 2019). The objective was to validate the predictive value of KELIM in 1st line treatment (with primary debulking surgery) on the data of 3 large phase III trials, and to integrate it in a Platinum-Resistant Recurrence Score.
Methods
Data from AGO-OVAR 9 (carboplatin-paclitaxel (CP) +/- gemcitabine); AGO-OVAR 7 (CP +/- topotecan); and ICON 7 trials (CP +/- bevacizumab) were analyzed. The predictive value of individual modeled KELIM regarding the risk of subsequent PtRR was assessed with other prognostic factors (stages; histological subtypes; grades; arms; GCIG CA125 criteria; Oza groups in ICON 7) using multivariate ROC curve & logistic models.
Results
Among assessable 2868 patients, 208 patients experienced subsequent PtRR (7.2%). Median KELIM (days-1) gradually increased with the subsequent PFIs: <6 months, 0.043; 6-12 months, 0.052; > 12 months, 0.065 (P < 0.05). Using multivariate logistic models, 3 covariates were significantly associated with PtRR risk: continuous KELIM (OR, 0.17 95% CI [0.11-0.25]; disease stage III (OR, 7.51 [3.70-18.02]); or stage IV (OR, 19.28 [9.06-47.80]); or Oza high risk group in ICON7 (OR 2.35 [1.79-3.10]). They were integrated in a Platinum-Resistant Recurrence Score meant to predict the individual risk of subsequent PtRR (i.e. risk calculated at 60% if KELIM = 0.2 and stage III).
Conclusions
Modeled KELIM, easily calculable online with three CA125 values observed during the first 100 adjuvant chemotherapy days (http://www.biomarker-kinetics.org/), is related to primary chemoresistance and survival. It has been integrated in a Platinum Resistant Recurrence Score that predicts the individual risk of PtRR in 1st line setting.
Clinical trial identification
Editorial acknowledgement
No assistance
Legal entity responsible for the study
ARCAGY-GINECO.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3082 - Prognostic and predictive role of body mass index (BMI) in metastatic colorectal cancer (mCRC): a pooled analisys of TRIBE and TRIBE-2 studies by GONO
Presenter: Emanuela Dell'Aquila
Session: Poster Display session 2
Resources:
Abstract
3618 - Drug holidays and overall survival in patients treated for metastatic colorectal cancer
Presenter: Silvio Ken Garattini
Session: Poster Display session 2
Resources:
Abstract
6111 - Quality of life during 1st-line FOLFOXIRI+/- panitumumab in RAS wild-type metastatic colorectal cancer: Results from the randomized VOLFI trial (AIO KRK-0109)
Presenter: Michael Geissler
Session: Poster Display session 2
Resources:
Abstract
1042 - A biomarker combination indicating resistance to FOLFOX plus bevacizumab in metastastic colorectal cancer : results of phase I of the PERMAD trial
Presenter: Thomas Seufferlein
Session: Poster Display session 2
Resources:
Abstract
3291 - Microsatellite Instability (MSI) status and prognosis in colorectal cancer: meta-analysis
Presenter: James Toh
Session: Poster Display session 2
Resources:
Abstract
2046 - Choosing the right strategy based on individualized treatment effect predictions: Combination versus sequential chemotherapy in patients with metastatic colorectal cancer.
Presenter: Miriam Koopman
Session: Poster Display session 2
Resources:
Abstract
2589 - Noninferiority on overall survival of every-2-weeks vs weekly schedule of cetuximab for first-line treatment of RAS wild-type metastatic colorectal cancer
Presenter: Stefan Kasper
Session: Poster Display session 2
Resources:
Abstract
4944 - POLAF study: Efficacy and safety of FOLFIRI/aflibercept in a phase II trial in patients with metastatic colorectal cancer: Results of plasmatic prognostic and predictive markers
Presenter: Maria Elena Elez Fernandez
Session: Poster Display session 2
Resources:
Abstract
2042 - The accuracy of the clinical PCI score in patients with peritoneal carcinomatosis of colorectal cancer
Presenter: Nadine De Boer
Session: Poster Display session 2
Resources:
Abstract
2667 - The impact of late-line treatment on overall survival (OS) from the initiation of first-line chemotherapy (CT) for patients (pts) with metastatic colorectal cancer (mCRC).
Presenter: Takeshi Kawakami
Session: Poster Display session 2
Resources:
Abstract