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
3191 - The efficacy and safety of lenvatinib in patients who did not meet the inclusion criteria of the phase 3 trial (REFLECT trial) and those with BCLC Stage B hepatocellular carcinoma - A nationwide multicenter study in Japan-
Presenter: Azusa Sakamoto
Session: Poster Display session 2
Resources:
Abstract
1529 - Prognostic and predictive value of baseline alpha-fetoprotein (AFP) in patients with advanced hepatocellular carcinoma (HCC) treated with ramucirumab from two phase 3 studies (REACH, REACH-2)
Presenter: Andrew Zhu
Session: Poster Display session 2
Resources:
Abstract
2767 - Effect of second-line cabozantinib on health states for patients with advanced hepatocellular carcinoma (aHCC) after sorafenib: QTWiST analysis from the CELESTIAL study
Presenter: Nicholas Freemantle
Session: Poster Display session 2
Resources:
Abstract
2150 - Alpha-fetoprotein (AFP) response in patients with unresectable hepatocellular carcinoma (HCC) in the phase 3 RESORCE trial
Presenter: Jordi Bruix
Session: Poster Display session 2
Resources:
Abstract
3437 - Phase I/II trial of NBTXR3 activated by SBRT in patients with hepatocellular carcinoma or liver metastasis
Presenter: Marc Pracht
Session: Poster Display session 2
Resources:
Abstract
1758 - Efficacy and safety of ramucirumab (RAM) for advanced hepatocellular carcinoma (HCC) with elevated alpha-fetoprotein (AFP) following first-line sorafenib across age subgroups in two global phase 3 trials (REACH and REACH-2)
Presenter: Masatoshi Kudo
Session: Poster Display session 2
Resources:
Abstract
1192 - Ramucirumab in patients with advanced hepatocellular carcinoma (HCC) and elevated alpha fetoprotein (AFP): An exposure–response analysis
Presenter: Josep Llovet
Session: Poster Display session 2
Resources:
Abstract
1600 - Outcomes of Hepatocellular Carcinoma (HCC) Patients Treated with Nivolumab: The Mount Sinai Hospital Experience.
Presenter: Sirish Dharmapuri
Session: Poster Display session 2
Resources:
Abstract
2364 - Pembrolizumab vs Chemotherapy in Patients With Advanced/Metastatic Adenocarcinoma (AC) or Squamous Cell Carcinoma (SCC) of the Esophagus as Second-Line Therapy: Analysis of the Chinese Subgroup in KEYNOTE-181
Presenter: Jia Chen
Session: Poster Display session 2
Resources:
Abstract
1933 - A national comparative effectiveness study to assess definitive chemoradiation regimens in proximal oesophageal squamous cell cancer
Presenter: Judith de Vos-Geelen
Session: Poster Display session 2
Resources:
Abstract