Abstract 426P
Background
Changes in prevalence and therapeutic landscapes of mCRC have translated into a progressive increase of refMCRC population. The efficacy of the available therapies in this setting is limited. Prognostic groups have been evaluated to determine better which patients (pts) could benefit from late-line treatments. We aim to explore the numeric representation of these groups in a real population that would support this strategy as a tool in daily care.
Methods
A cohort of mCRC pts treated at our hospital was retrospectively reviewed using medical charts from 2010 to 2020. Clinical, laboratory and molecular data were evaluated. We divided pts into 3 clinical groups according to previously reported prognostic characteristics: Good Prognostic Characteristics (GPC) defined as ≥18 m since metastatic disease debut, <3 metastatic sites and presence of liver metastasis, Best Prognostic Characteristics (BPC) defined as ≥18 m, since metastatic disease debut, < 3 metastatic sites and absence of liver metastases and Poor Prognostic Characteristics (PPC) defined as < 18m since metastatic disease debut and/or ≥3 metastatic sites. Statistical analysis was done using R version 4.
Results
A total of 735 out of 2365 mCRC pts (35%) were identified as refMCRC. Median age at diagnosis was 59 years, 130 pts (18%) were < 50y. Molecular profiles were: KRAS mutant (mt): 339 (46%), BRAF mt: 87 (12%) and MSI-H 29 (4%). In our cohort, 408/735 (55.51%) pts received > 3 lines of therapy (median lines 4, IQR 3-8) and 50.98% of these pts were included in clinical trials. The prognostic subgroup classification was: 266 pts (36%) GPC, 136 (19%) BPC and 333 (45%) PPC. The mOS of the cohort was 12.6m (11.4-13.9) and OS according to Prognostic Characteristics was: GPC 14.1m (11.8-16.4), BPC 16m (14.6-19.4) and PPC 10m (8.3-11.5).
Conclusions
According to data previously reported, prognostic characteristic subgroups are well represented in this cohort with a similar distribution and survival outcomes. We should further explore the potential utility of this tool in routine clinical practice or clinical trials. Of note, 35% of the pts in our series received a third-line therapy and more than a half were included in clinical trials with longer mOS compared to previous data.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
F. Salva: Financial Interests, Personal, Research Grant: Hoffman-La Roche; Sanofi Aventin; Amgen; Merck Serono; Servier; Bristol-Myers Squibb; Financial Interests, Personal, Advisory Board: Hoffman-La Roche; Sanofi Aventin; Amgen; Merck Serono; Servier; Bristol-Myers Squibb; Financial Interests, Personal, Sponsor/Funding: Hoffman-La Roche; Sanofi Aventin; Amgen; Merck Serono; Servier; Bristol-Myers Squibb; Financial Interests, Institutional, Other: Hoffman La-Roche. J. Ros: Financial Interests, Personal, Advisory Role: Sanofi; Financial Interests, Institutional, Other, Clinical trial investigator: Bristol-Myers Squibb; Financial Interests, Institutional, Advisory Role: Servier; Financial Interests, Personal, Other, Travel, Accommodations, Expenses: Sanofi. I. Baraibar: Financial Interests, Personal, Advisory Role: Sanofi; Financial Interests, Personal, Other, Travel, Accommodations, Expenses: Amgen; Sanofi; Financial Interests, Personal, Other, Honoraria: Sanofi. G. Argiles Martinez: Financial Interests, Personal, Advisory Role: Bayer; Bristol-Myers Squibb; Genentech/Roche; Roche; Servier; Financial Interests, Personal, Other, Travel, Accommodations, Expenses: Servier; Roche; Bayer; Amgen. J.L. Cuadra Urteaga: Financial Interests, Personal and Institutional, Sponsor/Funding: Amgen; Lilly. J. Capdevila: Financial Interests, Personal, Advisory Role: Novartis; Ipsen; Exelixis; Bayer; Eisai; AAA; Amgen; Sanofi; Merck; Financial Interests, Institutional, Other, Honoraria: Eisai; Novartis; Ipsen; AstraZeneca; Pfizer; AAA. D. Paez: Financial Interests, Personal, Speaker’s Bureau: Merck Serono; F. Hoffmann-La Roche Ltd; Financial Interests, Personal, Advisory Role: Amgen; Sanofi. G. Villacampa Javierre: Financial Interests, Personal, Speaker’s Bureau: Merck; Astra-Zeneca. Financial Interests, Personal, Expert Testimony: Merck; Financial Interests, Personal, Advisory Role: Astra-Zeneca; R. Dienstmann: Financial Interests, Personal, Advisory Role: Roche; Boehringer Ingelheim; Financial Interests, Personal, Speaker’s Bureau: Roche; Ipsen; Amgen; Sanofi; Libbs; Merck Sharp & Dohme; Financial Interests, Personal, Research Grant: Merck; Pierre Fabre. M.E. Elez Fernandez: Financial Interests, Personal, Advisory Role: Hoffman La - Roche; Bristol Myers Squibb; Servier; Amgen; Merck Serono; Sanofi; Bayer; Array Biopharma; Financial Interests, Personal, Research Grant: Hoffman La - Roche; Bristol Myers Squibb; Servier; Amgen; Merck Serono; Sanofi; Bayer; Array Biopharma; Financial Interests, Personal, Other, Travel grants: Hoffman La - Roche; Bristol Myers Squibb; Servier; Amgen; Merck Serono; Sanofi; Bayer; Financial Interests, Institutional, Other, Investigator contribution in clinical trials: Array Biopharma; MSD; AbbVie; Amgen; GlaxoSmithKline; AstraZeneca; Merck Sharp & Dohme Corp; Bristol Myers Squibb; Novartis; Boehringer Ingelheim; Hoffman La-Roche; Medimmune; Pierre-Fabre; Sanofi Aventis. J. Tabernero: Financial Interests, Personal, Advisory Role: Array Biopharma; AstraZeneca; Avvinity; Bayer; Boehringer Ingelheim; Chugai; Daiichi Sankyo; F. Hoffmann-La Roche Ltd; Genentech Inc; HalioDX SAS; Hutchison MediPharma International; Ikena Oncology; IQVIA; Lilly; Menarini; Merck Serono; Merus; MSD; Mirati; Neophore; Novartis; Orion Biotechnology; Peptomyc; Pfizer; Pierre Fabre; Samsung Bioepis; Sanofi; Seattle Genetics; Servier; Taiho; Tessa Therapeutics; TheraMyc; Financial Interests, Personal, Other: Imedex; Medscape Education; MJH Life Sciences; PeerView Institute for Medical Education and Physicians Education Resource (PER). All other authors have declared no conflicts of interest.