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Poster Display session 3

3808 - GOLFIG chemo-immunotherapy in metastatic colorectal cancer (mCRC) patients: A fifteen year retrospective analysis

Date

30 Sep 2019

Session

Poster Display session 3

Topics

Immunotherapy

Tumour Site

Presenters

Pierpaolo Correale

Citation

Annals of Oncology (2019) 30 (suppl_5): v475-v532. 10.1093/annonc/mdz253

Authors

P. Correale1, N. Staropoli2, P. Pastina3, R. Giannicola1, C. Botta2, E. Francini4, L. Ridolfi5, E. Mini6, D. Ciliberto2, R.M. Agostino1, A. Strangio1, D. Azzarello1, V. Nardone7, A. Falzea1, P. Tassone2, A. Giordano8, L. Pirtoli8, G. Francini4, P.S. Tagliaferri2

Author affiliations

  • 1 Medical Oncology Unit, "Bianchi-Melacrino-Morelli" Grand Metropolitan Hospital, 89125 - Reggio Calabria/IT
  • 2 Medical Oncology Unit, Departement of Experimental and Clinical Medicine, Magna Graecia University, 88100 - Catanzaro/IT
  • 3 Unità Di Radioterapia, Azienda Ospedaliera Universitaria Senese-Istituto Toscano Tumori, 53100 - Siena/IT
  • 4 Medical Oncology Unit, Siena University Hospital, 53100 - Siena/IT
  • 5 Immunotherapy, Cell Therapy and Biobank, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, 47014 - Meldola/IT
  • 6 Oncology, Azienda Ospedaliera Universitaria Careggi, 50134 - Firenze/IT
  • 7 Unit Of Radiation Oncology, Ospedale del Mare, 80147 - Napoli/IT
  • 8 Biology, College of Science and Technology, Temple University, 19122 - USA/US

Resources

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Abstract 3808

Background

Immune-checkpoint blockade has shown anti-tumor activity in MSI mCRC patients only, thus, the research of more efficacious immunological strategies for colon cancer treatment is still open. GOLFIG, is a safe and active chemo-immunotherapy regimen designed on the basis of preclinical immune-oncological findings and evaluated in two subsequent Phase II and III trials in mCRC patients (J Clin Oncol, 2005,23:8950; J Immunother, 2014;37:26). This regimen combines gemcitabine + FOLFOX poly-chemotherapy with salgramostim (GM-CSF) and low dose sc. aldesleukin, to improve both cross-priming and T-cell effector anti-tumor response. Here we report a fifteen-year retrospective analysis of all patients undergone this therapeutic approach.

Methods

This is a multi-institutional real-life study including one hundred-seventy-nine mCRC patients receiving GOLFIG regimen between October 2001 and November 2018 with a median follow up of 120 months. The treatment was administered to 62 patients (GOLFIG-2 trial, EUDRACT: 2005-003458-81) as a first-line and to 117 patients as second/third-line (49 enrolled in the GOLFIG-1 phase II trial and 68 as real life). Kaplan-Meier and Cox-regression were carried-out to relate their PFS and OS with sex, age, sidedness, RAS mutational status, previous treatment lines, baseline clinical parameters and treatment-related irAEs.

Results

We recorded a PFS and OS of 15.3 (95%CI:10.4-20.2) and 24.6 (95%CI:19.07-30.14) months, respectively, with 10% of the patients surviving more than ten years. Patients’ outcome did not correlate with sex, sidedness and RAS. First line GOLFIG confirmed superiority over FOLFOX in term of PFS (HR = 0.58 p = 0.006) and OS (HR = 0.69, P = 0.06) (updated from GOLFIG-2 trial). Patients in first-line showed a longer PFS (HR = 0.69; p = 0.041) compared with the others, with no difference in OS. On the overall, a longer PFS and OS correlated with baseline neutrophil counts ≤ 4,500 cells/µl (HR:0.32; P = 0.003) and occurrence of irAEs (HR = 0.36; P = 0.0001) recorded in 24% of the cases.

Conclusions

These results confirm that the GOLFIG regimen is a reliable therapy for pretreated mCRC patients and offer the rationale to design combination trials with immune-checkpoint blockade.

Clinical trial identification

1) GOLFIG-2 phase III trial; EudraCT: 2005-003458-81 2) GOLFIG-1 phase II trial; EudraCT no available, start July 2001.

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Italian Ministry of Education and Research (MIUR) (2009EHW394). Private grant from the “Associazione Culturale Federico II,” and from the “Associazione Riuniti Calabria Oncologia (ARCO)”.

Disclosure

All authors have declared no conflicts of interest.

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