Abstract 62P
Background
Neoadjuvant chemotherapy (NCT) in pts with LACC is a promising option. However, there is limited information on the effectiveness of such an approach in different clinical subgroups because of conflicting results from studies. Therefore, we performed a systemic review and meta-analysis to compare efficacy of NCT in pts with LACC.
Methods
We performed a search of all prospective randomized phase II-III studies in PubMed, ASCO and ESMO congresses for all years before December 2023, NCT with oxaliplatin and fluoropyrimidines in pts with LACC. Primary outcome was hazard ratio (HR) for OS and 95% confidence interval (CI); secondary – HR for disease free survival (DFS). Fixed or random effects were used for analysis, depending on heterogeneity. Meta-analysis was conducted by WebPlotDigitizer and «Review Manager» Ver. 5.3.
Results
We identified 4 trials (PRODIGE 22, FOXTROT, OPTICAL and NEOCOL), which included 2149 pts (neoadjuvant – 1248 and surgery – 901). According to results of the meta-analysis there was a significant improvement in DFS (HR 0.79, 95% CI 0.65-0.96; p = 0.02; I2 = 0%, p for heterogeneity 0.73; 4 trials) and OS (HR 0.74, 95% CI 0.57-0.95; p = 0.01; I2 = 24%, p for heterogeneity 0.27; 4 trials) in group with NCT. DFS was improved in pts with MSS status (HR 0.66, 95% CI 0.48-0.9; p = 0.009; I2 = 0%, p for heterogeneity 0.41; 2 trials), in women (HR 0.63, 95% CI 0.38-1.03; p = 0.06; I2 = 34%, p for heterogeneity 0.22; 2 trials), with left-sided tumors (HR 0.73, 95% CI 0.54-0.97; p = 0.04; I2 = 0%, p for heterogeneity 0.4; 3 trials) and index cT4 (HR 0.72, 95% CI 0.54-0.96; p = 0.03; I2 = 0%, p for heterogeneity 0.6; 3 trials), but not in men, MSI tumors, right-sided tumors and cT3.
Conclusions
NCT in locally advanced colon cancer may be considered in pts with T4, left-sided and MSS tumors. However, these findings require validation prospectively.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.