Abstract 2877
Background
The purpose of this study was to explore the impact of completeness of weekly irinotecan combined with capecitabine-based preoperative chemoradiotherapy in patients with locally advanced rectal cancer (LARC).
Methods
LARC patients receiving neoadjuvant CRT between May 2011 and February 2018 were enrolled. The paradigm included preoperative pelvic RT (50 Gy/25Fx) concurrently with capecitabine (625 mg/m2, bid, d1-5) and irinotecan (80 mg/m2 for UGT1A1*1*1 genotype or 65 mg/m2 for UGT1A1*1*28 genotype, qw), followed by a course of XELIRI and surgery. The actual cycles of concurrent irinotecan delivered was reviewed from the electronic records. Patients were divided into the low-completeness group (1∼3 cycles) and the high-completeness group (4∼5 cycles). Univariate and multivariate analyses were performed to identify risk factors of the completeness. A nomogram was built to divide patients into 3 groups with different risk.
Results
A total of 371 patients were enrolled, with 102 patients from a phase III clinical trial (CinClare, NCT02605265). The proportion of patients with low completeness was 32.4% versus 67.6% with high completeness in the CinClare group, and 41.3% versus 58.7% in the remaining group (p = 0.12). In the CinClare group, the complete response (CR) rate was 24.2% in the low-completeness patients versus 42.6% in the high-completeness patients (p = 0.07). The difference was more significant in the general population (28.6% vs 71.6%, p = 0.02). Univariate analysis showed age over 60, female, anemia at baseline, and a low pretreatment pre-Alb level were associated with a low completeness. By using multivariate analysis and building a nomogram, we could divide patients into 3 groups: (1) high-risk group (risk score>200); (2) intermediate-risk group (score 100∼200); (3) low-risk group (score≤100). The rates of high completeness in the 3 groups were 27.8%, 47.6% and 69.5%, respectively.
Conclusions
Our analysis suggested a higher completeness of weekly irinotecan was associated with a higher CR rate. Comprehensive evaluation of the patient performance is necessary before starting the intensified treatment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3911 - Defining a SUV decrease cut-off in PET/CT response monitoring after one cycle of preoperative breast cancer chemotherapy
Presenter: Marcin Kubeczko
Session: Poster Display session 2
Resources:
Abstract
1849 - Effect of thioredoxin 1 quantity detection to complement the mammography in breast cancer diagnosis
Presenter: Younju Lee
Session: Poster Display session 2
Resources:
Abstract
2221 - Identification of ultralow risk breast cancer patients (probable overdiagnosis)
Presenter: Salvador Gamez Casado
Session: Poster Display session 2
Resources:
Abstract
5291 - Prevalence of Vitamin D3 deficiency among women with early breast cancer receiving chemotherapy in an oncology dayward.
Presenter: Warner Finstad
Session: Poster Display session 2
Resources:
Abstract
4247 - Changes in ER pathway activity score during neoadjuvant letrozole to assess therapy response and predict disease free survival (DFS) in ER positive breast cancer patients
Presenter: Arran Turnbull
Session: Poster Display session 2
Resources:
Abstract
568 - Second primary malignancies in patients with breast cancer.
Presenter: Carlos Erasun Lecuona
Session: Poster Display session 2
Resources:
Abstract
1428 - Phase II randomized trial of neoadjuvant trastuzumab and pertuzumab (TP) with either palbociclib + letrozole (Pal+L) or paclitaxel (Pac) for elderly patients with estrogen receptor & HER2 positive (ER+/HER2+) Breast Cancer (BC) (International Breast Cancer Study Group IBCSG 55-17, TOUCH)
Presenter: Laura Biganzoli
Session: Poster Display session 2
Resources:
Abstract
1479 - Neoadjuvant HER2-targeted therapy with or without immunotherapy with pembrolizumab (neoHIP): an open label randomized phase 2 trial
Presenter: Heather McArthur
Session: Poster Display session 2
Resources:
Abstract
1481 - A randomized phase 2 study of peri-operative ipilimumab, nivolumab and cryoablation versus standard care in women with residual, early stage/resectable, triple negative breast cancer after standard-of-care neoadjuvant chemotherapy
Presenter: Heather McArthur
Session: Poster Display session 2
Resources:
Abstract
4334 - ALEXANDRA/IMpassion030: A phase 3 study of standard adjuvant chemotherapy with or without atezolizumab in early stage triple negative breast cancer.
Presenter: Michail Ignatiadis
Session: Poster Display session 2
Resources:
Abstract