This randomized trial demonstrates that the addition of cetuximab to CAPIRI or CAPOX is effective and safe in first-line treatment of mCRC. In the analyzed regimens, ORR and PFS did not differ according to KRAS gene mutation status.

PurposeAIO KRK-0104 investigated first-line therapy of metastatic colorectal cancer (mCRC) with cetuximab, capecitabine and irinotecan versus cetuximab, capecitabine and oxaliplatin. This analysis investigated the impact of primary tumor location on outcome of patients.Patients and methodsLeft-sided primary tumors were defined as tumors from rectum to left flexure, while tumors in the remaining colon were regarded right sided. Overall survival (OS), progression-free survival (PFS) and response rate were correlated with primary tumor location. A Cox regression model was used to evaluate interaction between primary tumor location and KRAS mutation.ResultsOf 146 patients of the AIO KRK-0104 trial, 100 patients presented left-sided (of those 68 KRAS codon 12/13 wild-type) and 46 patients right-sided primary tumors (of those 27 KRAS codon 12/13 wild-type). Left-sided tumors were associated with significantly longer OS (p = 0.016, HR = 0.63) and PFS (p = 0.02, HR = 0.67) as compared to right-sided tumors. These effects were present in the KRAS codon 12/13 wild-type population (HR OS: 0.42; HR PFS: 0.54), while no impact of primary tumor location was evident in patients with KRAS codon 12/13 mutant tumors (HR OS: 1.3; HR PFS: 1.01). A significant interaction of KRAS status and primary tumor location concerning OS and PFS was observed.ConclusionOur findings suggest that primary tumor location and KRAS codon 12/13 mutational status interact on the outcome of patients with mCRC receiving cetuximab-based first-line therapy. Left-sided primary tumor location might be a predictor of cetuximab efficacy.

We evaluated the expression patterns of proapoptotic BAX, antiapoptotic Bcl-2 and p53, the proposed upstream effector of these molecules, as potential prognostic markers in UICC stage III colon cancer by immunohistochemical staining. To identify highfrequency microsatellite instability (MSI þ ) individuals, we performed single-strand conformation polymorphism-based analysis for BAT26. A total of 188 patients who had received 5-fluorouracil (5-FU)-based adjuvant chemotherapy (5-FU/folinic acid or 5-FU/ levamisole) were enrolled. Median follow-up was 84.5 months. We found that BAX, Bcl-2 and p53 protein expressions were high or positive in 59, 70 and 50% of 188 cases, respectively. MSI þ tumours were detected in 9% of 174 evaluable patients. BAX or Bcl-2 was correlated with a higher degree of differentiation or left-sided tumours (P ¼ 0.01 or P ¼ 0.03, respectively); MSI was correlated with right-sided tumours (Po0.0001). In contrast to p53, Bcl-2, or MSI, low BAX, advanced pN category, low grade of differentiation and treatment with 5-FU/levamisole were univariately associated with poorer disease-free survival (DFS) (P ¼ 0.0005, P ¼ 0.001, P ¼ 0.005 and P ¼ 0.01, respectively) and poorer overall survival (OS) (P ¼ 0.002, P ¼ 0.0001, P ¼ 0.003 and P ¼ 0.02, respectively). Besides pN category and treatment arm, BAX was an independent variable related to both OS and DFS (P ¼ 0.003 and P ¼ 0.001, respectively). In both univariate and multivariate analysis, the p53À/BAX high in comparison with the p53 þ /BAX high subset conferred a significantly improved DFS (P ¼ 0.03 and P ¼ 0.03, respectively) as well as a marginally improved OS (P ¼ 0.07 and P ¼ 0.08, respectively). BAX protein expression may be of central significance for clinical outcome to 5-FU-based adjuvant chemotherapy in stage III colon cancer, and bivariate analysis of p53/BAX possibly may provide further prognostic evidence.

Aim: The aim of this study was to evaluate survival rates and treatment response in stage I–IV gastric cancer in relation to tumor stage (TNM), histology, Lauren’s classification and tumor localization. Patients and Methods: Clinical and histopathological data of 160 patients with stage I–IV gastric cancer were analyzed in this retrospective, single-center study. Results: Most patients (73.1%) showed an advanced or metastatic tumor stage (III/IV). The median 3-year overall survival (OS) was 20 ± 16.8 months and correlated significantly with tumor stage (I: OS 30.6 ± 15 months vs. IV: 10.4 ± 9.3 months; p < 0.0001). Stage III/IV tumors were significantly more often poorly differentiated (G3; p = 0.011) and located in the corpus region. Signet ring cell (SRC) cancers were found in a larger proportion of these tumors when compared with locally limited gastric cancers (43.1% vs. 16.3%; p = 0.002). SRC tumors occurred predominantly in women and younger patients and histology was significantly more often of the diffuse subtype according to Lauren (7.5% vs. 63.2%; p < 0.0001) and poorly differentiated (G3 in 95% vs. 73%; p = 0.001). Conclusions: SRC gastric cancer correlates with poor histopathological criteria and poor prognosis when compared with other histological subtypes. These observations underline the need for more effective treatment in addition to standard approaches.

Background: Among patients with breast or gynecological cancer, supportive care needs are both highly prevalent and enduring. However, little is known about whether meeting patients' needs is accompanied by increased quality of life (QoL). We aimed to explore patients' supportive care needs reported at the beginning of inpatient rehabilitation and examined whether meeting these needs resulted in improved QoL. Material and methods: In a multicenter, prospective cohort study with 2 measurement occasions (beginning and end of inpatient rehabilitation), 292 patients with breast and gynecological cancer (mean age 55 years; 71% breast cancer) were enrolled. In 73%, time since diagnosis was longer than 6 months. We obtained self-reports of supportive care needs in 12 domains and measured QoL using the EORTC QLQ-C30 functioning subscales. Results: At the beginning of inpatient rehabilitation, top-ranking severe supportive care needs concerned coordination of care (48%), medical information (45%), alleviation of physical symptoms (42%) and support with improving health behaviors (36%). At the end of inpatient rehabilitation, all needs assessed declined significantly, although many patients still expressed strong needs in some domains. However, meeting patients' needs was accompanied by improvements in all functioning subscales. Conclusions: This is the first study to show that meeting breast and gynecological cancer patients' supportive care needs during inpatient rehabilitation resulted in improved QoL. Given the considerable proportions of patients still reporting unmet needs at the end of their stay, stronger and continuing efforts seem warranted to meet these needs and thus further increase QoL. ARTICLE HISTORY