An appraisal of emerging second line therapies for metastatic colorectal cancer

Smolenschi, Cristina; Perret, Audrey; Dall'Armellina, François; Boige, Valérie; Malka, David; Hollebecque, Antoine; Ducreux, Michel

doi:10.1080/17474124.2021.1840975

Cited by 2 publications

(1 citation statement)

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“…Altogether, since intensive conversion PO-SACT, including triplet with biologicals or hepatic artery infusion, is associated with high response and secondary resection rates [ 46 , 47 ], even when used as salvage options in pre-treated patients [ 26 , 48 , 49 ], it could be argued that if an intensive regimen is the only valid therapeutic option in selected patients with unresectable liver-predominantly metastases, the choice of the triplet, a biological, hepatic artery infusion or a combination of them within an aggressive onco-surgical strategy can still be expected to be associated with overall better survival chances than with a bland palliative chemotherapy, even in second-line [ 16 , 50 , 51 ]. Thus, the more effective is the conversion chemotherapy, the higher is the chance of inducing resectability of previously unresectable patients [ 4 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of Preoperative Chemotherapy Features on Patient Outcomes after Hepatectomy for Initially Unresectable Colorectal Cancer Liver Metastases: A LiverMetSurvey Analysis

Innominato

Cailliez

Allard

et al. 2022

Cancers

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Background: Prognostic factors have been extensively reported after resection of colorectal liver metastases (CLM); however, specific analyses of the impact of preoperative systemic anticancer therapy (PO-SACT) features on outcomes is lacking. Methods: For this real-world evidence study, we used prospectively collected data within the international surgical LiverMetSurvey database from all patients with initially-irresectable CLM. The main outcome was Overall Survival (OS) after surgery. Disease-free (DFS) and hepatic-specific relapse-free survival (HS-RFS) were secondary outcomes. PO-SACT features included duration (cumulative number of cycles), choice of the cytotoxic backbone (oxaliplatin- or irinotecan-based), fluoropyrimidine (infusional or oral) and addition or not of targeted monoclonal antibodies (anti-EGFR or anti-VEGF). Results: A total of 2793 patients in the database had received PO-SACT for initially irresectable diseases. Short (<7 or <13 cycles in 1st or 2nd line) PO-SACT duration was independently associated with longer OS (HR: 0.85 p = 0.046), DFS (HR: 0.81; p = 0.016) and HS-RFS (HR: 0.80; p = 0.05). All other PO-SACT features yielded basically comparable results. Conclusions: In this international cohort, provided that PO-SACT allowed conversion to resectability in initially irresectable CLM, surgery performed as soon as technically feasible resulted in the best outcomes. When resection was achieved, our findings indicate that the choice of PO-SACT regimen had a marginal if any, impact on outcomes.

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