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
3425 - Feasibility and impact of prospective DPYD screening in the Irish population
Presenter: Mohammed Zameer
Session: Poster Display session 2
Resources:
Abstract
1972 - Diet-derived metabolites and the risk of colorectal cancer: a nested case-control study in a population-based cohort, the Singapore Chinese Health Study
Presenter: Dawn Chong
Session: Poster Display session 2
Resources:
Abstract
4103 - Loss of subcutaneous adipose tissue during chemotherapy predicts reduced survival in patients with incurable colorectal cancer undergoing palliative therapy
Presenter: Erin Stella Sullivan
Session: Poster Display session 2
Resources:
Abstract
4309 - Obese and overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab.
Presenter: Bozena Cybulska-Stopa
Session: Poster Display session 2
Resources:
Abstract
3554 - Patient characteristics associated with poor performance status, ECOG 2-3, and effect on survival in 1086 Finnish metastatic colorectal cancers (mCRC) nationwide (prospective RAXO study)
Presenter: Pia Österlund
Session: Poster Display session 2
Resources:
Abstract
4572 - Discovery and Diagnosis of Metastatic Colorectal Cancer (mCRC) in the Real World: Final Results from a European Survey
Presenter: Iga Rawicka
Session: Poster Display session 2
Resources:
Abstract
4783 - Adherence to recommended intake of calcium and colorectal cancer risk in the HEXA study
Presenter: Jeeyoo Lee
Session: Poster Display session 2
Resources:
Abstract
5106 - Body size, sex and sidedness of incident colorectal cancer in a prospective Swedish cohort study
Presenter: Christina Siesing
Session: Poster Display session 2
Resources:
Abstract
3364 - Middle East & North Africa Registry to characterize RAS mutation status and tumor specifications in recently diagnosed patients with metastatic colorectal cancer (MORE-RAS Study)
Presenter: Mohamed Oukkal
Session: Poster Display session 2
Resources:
Abstract
3668 - Patient Demographics and Management Landscape of Metastatic Colorectal Cancer in the Third Line Setting: real-world data in an Australian Population
Presenter: Sandy Tun Min
Session: Poster Display session 2
Resources:
Abstract