Impact of early tumour shrinkage and resection on outcomes in patients with wild-type RAS metastatic colorectal cancer

Douillard, Jean-Yves; Siena, Salvatore; Peeters, Marc; Koukakis, Reija; Terwey, Jan-Henrik; Tabernero, Josep

doi:10.1016/j.ejca.2015.03.026

Cited by 74 publications

(94 citation statements)

References 23 publications

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“…ETS, defined as P20% tumour shrinkage at 8 weeks, was observed in 80% of the 57 patients enrolled in the trial. PFS for patients with ETS was significantly prolonged compared with patients without ETS (median PFS 11.5 versus 3.7 months, HR 0.25; 95% CI 0.12- [12,37,38] evaluated tumour response at week 8 in 584 randomised patients with KRASwt tumours according to RECIST (version 1.0) criteria with 30% as the cut-off and ETS defined as P20% at week 8 [38]. Again, the rate of ETS was greater in the panitumumab arm (69% versus 56%), where patients with ETS had a significantly longer PFS (11.0 versus 5.7 months) and OS (30.0 versus 10.7 months) compared to those with no ETS.…”

Section: Ets In Patients Receiving Chemotherapy Plus Egfrtargeting Mabsmentioning

confidence: 99%

Early tumour shrinkage (ETS) and depth of response (DpR) in the treatment of patients with metastatic colorectal cancer (mCRC)

Heinemann

Stintzing

Modest

et al. 2015

European Journal of Cancer

160

145

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Section: Ets In Patients Receiving Chemotherapy Plus Egfrtargeting Mabsmentioning

confidence: 99%

Early tumour shrinkage (ETS) and depth of response (DpR) in the treatment of patients with metastatic colorectal cancer (mCRC)

Heinemann

Stintzing

Modest

et al. 2015

European Journal of Cancer

160

145

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“…et al [11] and Douillard J.Y. [12] demonstrated that macroscopic liver resection was significantly associated with early tumor response on intravenous chemotherapy. In the present analysis, we determined both early and late responses according to RECIST criteria, qualifying early response as a PR or CR after three treatment courses.…”

Section: Discussionmentioning

confidence: 99%

“…In the same way, no significant association was found here between overall best objective response and complete macroscopic liver resection. Recent retrospective studies [12,13,24,25] have addressed this issue through considering early tumor shrinkage as a better indicator of more stringent efficacy outcomes. They defined early tumor response as a relative change of ≥ 20% in the sum of the largest diameters of target lesions at nearly 8 weeks compared to baseline.…”

Section: Discussionmentioning

confidence: 99%

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Early tumour response as a survival predictor in previously- treated patients receiving triplet hepatic artery infusion and intravenous cetuximab for unresectable liver metastases from wild-type KRAS colorectal cancer

Bouchahda

Boige

Smith

et al. 2016

European Journal of Cancer

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2016) Early tumour response as a survival predictor in previously-treated patients receiving triplet hepatic artery infusion and intravenous cetuximab for unresectable liver metastases from wild-type KRAS colorectal cancer. European Journal of Cancer Care, 68. pp. 163-172 Permanent WRAP URL: http://wrap.warwick.ac.uk/85119 Copyright and reuse:The Warwick Research Archive Portal (WRAP) makes this work by researchers of the University of Warwick available open access under the following conditions. Copyright © and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable the material made available in WRAP has been checked for eligibility before being made available.Copies of full items can be used for personal research or study, educational, or not-for profit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. Publisher's statement:"This is the peer reviewed version of the following article: Bouchahda, Mohamed, Boige, Valérie, Smith, Denis, Karaboué, Abdoulaye, Ducreux, Michel, Hebbar, Mohamed, Lepère, Céline, Focan, Christian, Guimbaud, Rosine, Innominato, Pasquale F. et al.. (2016) Early tumour response as a survival predictor in previously-treated patients receiving triplet hepatic artery infusion and intravenous cetuximab for unresectable liver metastases from wild-type KRAS colorectal cancer. European Journal of Cancer Care, 68. pp. 163-172 which has been published in final form at http://dx.doi.org/10.1016/j.ejca.2016.09.011 This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving." A note on versions:The version presented here may differ from the published version or, version of record, if you wish to cite this item you are advised to consult the publisher's version. Please see the 'permanent WRAP URL' above for details on accessing the published version and note that access may require a subscription. within a multicenter conversion-to-resection medico-surgical strategy. Confirmation is warranted for decision-making. Protocol numbersEUDRACT 2007-004632-24 NCT00852228 KEY WORDS:Early tumor response, colorectal cancer, liver metastases, hepatic artery infusion, triplet chemotherapy. ACKNOWLEDGEMENTS:We sincerely acknowledge the contribution of the patients who participated in this trial and all our colleagues and staff at the participating institutions.

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“…Achieving ETS leads to higher rate of treatment response, increased rates of resectability for initially unresectable CLMs, increased overall survival and longer progression-free survival rates in patients with KRAS WT CLMs (regardless the resectability) (118). Most studies showed that ETS is statistically significant more frequent when a combination of CHT with anti-EFGR antibodies is used (118)(119)(120).…”

Section: Liver Resection After Down-sizing Chemotherapymentioning

confidence: 99%

Surgical Options in Synchronous Liver Metastases from Colorectal Cancer

Alexandrescu¹,

Diaconescu²,

Popescu³

2017

JTMR

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Currently, the treatment of liver metastases of colorectal cancer (CRC) requires a multidisciplinary approach and should be individualized for each patient. Liver resection provides 5 years survival rates ranging between 30 and 58% in patients with liver metastases of CRC. The optimal timing of liver resection, resection of the primary tumor and neoadjuvant chemotherapy has not been fully established, yet, neither for initially resectable synchronous liver metastases, nor for those initially unresectable which could be converted to resectability. Advocates of simultaneous resection and those of staged resection (delayed liver resection or "liver first approach"), both presented theoretical arguments in favor of each of these therapeutic strategies. Progresses in liver surgery, anesthesia, intensive care and oncology caused a paradigm shift regarding the approach of synchronous colorectal liver metastases, with simultaneous resection (SR) becoming a safer procedure in the last decade. As well, the oncologic outcomes of SR are similar to those achieved by staged resection. In this review we present the literature data concerning the results achieved by each of the currently available therapeutic approaches. Abbreviations: CLMs -colorectal liver metastases, SCLMs -synchronous colorectal liver metastases, CRC -colorectal cancer, PVL-portal vein ligation, PVE -portal vein embolization, SR -simultaneous resection, DR -delayed liver resection, SgR -staged resections, FLR -future liver remnant, CHT -chemotherapy, OS -overall survival, DFS -disease-free survival, ETS -early tumor shrinkage

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Impact of early tumour shrinkage and resection on outcomes in patients with wild-type RAS metastatic colorectal cancer

Abstract: More patients receiving panitumumab+FOLFOX4 versus FOLFOX4 had ⩾30% or ⩾20% TS at week 8; PFS and OS were also improved with panitumumab+FOLFOX4. The clinical value of achieving early TS in mCRC warrants further investigation.

Cited by 74 publications

References 23 publications

Early tumour shrinkage (ETS) and depth of response (DpR) in the treatment of patients with metastatic colorectal cancer (mCRC)

Early tumour shrinkage (ETS) and depth of response (DpR) in the treatment of patients with metastatic colorectal cancer (mCRC)

Early tumour response as a survival predictor in previously- treated patients receiving triplet hepatic artery infusion and intravenous cetuximab for unresectable liver metastases from wild-type KRAS colorectal cancer

Surgical Options in Synchronous Liver Metastases from Colorectal Cancer

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