Abstract 77P
Background
Oxaliplatin based doublet: FOLFOX or CapeOX + targeted therapy (anti-VEGF or anti-EGFR) is used worldwide as the standard first-line treatment for mCRC. To optimize the use of this standard of care and to develop new treatments, the chronological change and current status of the clinical outcomes of this therapy need to be summarized.
Methods
4,613 pts of mCRC who received a first-line FOLFOX or CapeOX + targeted therapy were selected from 12 randomized studies (NO16966, CALGB80405, PRIME, CAIRO2, OPUS, TRIBE2, ATOM, WJOG4407G, SOFT, HORIZON III, PACCE and CCOG1201) from the ARCAD mCRC database. The endpoints of interest were overall survival (OS), progression-free survival (PFS) and post-progression survival (PPS). The IQR of the randomized year of each pt was used for categorization to summarize the chronological change of each endpoint.
Results
Median OSs (months) were 18.07 (17.48 - 26.35) in 2003-2004, 20.37 (19.65 - 22.18) in 2005-2006, 22.70 (21.32 - 23.92) in 2007-2008, and 26.94 (25.99 - 28.58) in 2009-2017. The results of PFS and PPS are shown in the table. Table: 77P
| OS | PFS | PPS | ||
| Median unit; mo (95% CI) | 2003-2004 | 18.07 (17.48 - 26.35) | 9.46 (9.17 - 10.12) | 8.39 (7.60 - 8.88) |
| 2005-2006 | 20.37 (19.65 - 22.18) | 9.79 (9.36 - 10.48) | 10.10 (8.98 - 10.92) | |
| 2007-2008 | 22.70 (21.32 - 23.92) | 9.86 (9.36 - 10.55) | 12.17 (11.31 - 13.35) | |
| 2009-2017 | 26.94 (25.99 - 28.58) | 11.04 (10.61 - 11.56) | 13.58 (12.76 - 14.63) | |
| HR (95%CI) ∗1 | 2003-2004 | 1.50 (1.28 - 1.76) | 1.47 (1.32 - 1.65) | 1.72 (1.45 - 2.05) |
| 2005-2006 | 1.42 (1.29 - 1.57) | 1.27 (1.16 - 1.38) | 1.37 (1.23 - 1.52) | |
| 2007-2008 | 1.31 (1.19 - 1.44) | 1.31 (1.20 - 1.42) | 1.10 (1.00 - 1.22) |
1Adjusted for ECOG-PS, age and sex, reference is 2009 - 2017.
Conclusions
The OS of FOLFOX or CapeOX + targeted therapy regimen was chronologically prolonged. It was due to prolonged PPS and may have been contributed by clinical developments in subsequent therapies such as late-line therapy and conversion surgery. In addition, the exclusion of RAS mutated pts in studies only for RAS wild type through the increased use of anti-EGFR antibodies may also contribute to longer OS.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.