Impact of primary tumor location in patients with RAS wild-type metastatic colon cancer treated with first-line chemotherapy plus anti-EGFR or anti-VEGF monoclonal antibodies: a retrospective multicenter study

Grassadonia, Antonino; Ficorella, Corrado; Cortellini, Alessio; Cannita, Katia; Parisi, Alessandro; Gamucci, Teresa; Zoratto, Federica; Vici, Patrizia; Barba, Maddalena; Porreca, Ettore; Neri, Matteo; Veronese, Angelo; Natoli, Clara; Tursi, Michele De; Tinari, Nicola

doi:10.7150/jca.34550

Cited by 27 publications

(21 citation statements)

References 44 publications

(65 reference statements)

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“…This is much lower when compared with that of the developed world, where the median OS for mCRC with the use of novel agents is now > 30 months. 17 , 19 , 20 , 22 We believe that the main explanation for this is poor availability of drugs and especially new targeted agents. Only few patients could afford these novel agents and receive them during the whole course of treatment.…”

Section: Discussionmentioning

confidence: 99%

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Treatment and Outcomes of Colorectal Cancer in Armenia: A Real-World Experience From a Developing Country

Bardakhchyan

Mkhitaryan²,

Zohrabyan

et al. 2020

JCO Global Oncology

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PURPOSE In Armenia, colorectal cancer (CRC) is one of the most frequently diagnosed cancers. It is in the third place by incidence. The aim of this study was to evaluate treatment and outcomes of CRC in Armenia during the last 9 years. MATERIALS AND METHODS For this retrospective hospital-based study, we have collected data from two main oncology centers in Armenia: National Oncology Center and “Muratsan” Hospital of Yerevan State Medical University. The information about patients with CRC who were treated at these two centers between January 1, 2010 and July 1, 2018 was collected from the medical records. Log-rank test and Kaplan-Meier curves were used for survival analysis. Prognostic factors were identified by Cox regression. RESULTS A total of 602 patients with CRC were involved in the final analysis. Median follow-up time was 37 months (range, 3-207 months). A total of 8.6% of patients had stage I, 32.9% stage II, 38.0% stage III, and 17.6% stage IV cancer; for 2.7% patients, the stage was unknown. The main independent prognostic factors for overall survival (OS) were tumor stage, grade, and histology. Adjuvant chemotherapy has been shown to improve survival in stage II colon cancer and stage III rectal but not in stage II rectal cancer. Radiotherapy did not yield survival improvement in stage II or III rectal cancer. Three- and 5-year OS rates were 62.9% and 51.8% for all stages combined and 79.7% and 68.5% for stages I-II, 62.5% and 48.4% for stage III, and 24.4% and 17% for stage IV respectively. CONCLUSION As seen from our results, our survival rates are lower than those of the developed world. Additional research is needed to identify the underlying reasons and to improve patients’ treatment and outcomes in Armenia.

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Section: Discussionmentioning

confidence: 99%

“… 7 , 9 , 18 As our armamentarium of available therapies grows, in some studies the sequential use of various chemotherapeutic and targeted therapy agents has shown improvement in median survival of mCRC > 30 months. 19 , 20 , 21 , 22 …”

Section: Introductionmentioning

confidence: 99%

Treatment and Outcomes of Colorectal Cancer in Armenia: A Real-World Experience From a Developing Country

Bardakhchyan

Mkhitaryan²,

Zohrabyan

et al. 2020

JCO Global Oncology

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“…Recently, a novel role of tumor location in the outcome of patients has been described. A more favourable outcome in left tumors than right tumors in wild-type KRAS CRC patients has been described [44,45].…”

Section: Introductionmentioning

confidence: 99%

KRAS and BRAF Mutations as Prognostic and Predictive Biomarkers for Standard Chemotherapy Response in Metastatic Colorectal Cancer: A Single Institutional Study

Garcia-Carbonero

Martínez‐Useros

et al. 2020

Cells

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KRAS mutation is a confirmed predictive biomarker for anti-EGFR monoclonal antibody therapy response for metastatic colorectal cancer. However, its prognosis impact and the predictive potential for first-line standard chemotherapy remains unclear. On the other hand, V600E mutation is the most frequent and studied mutation in the BRAF gene, and it has been associated with a poor outcome of patients and a low response to anti-EGFR treatment. Thus, the aim of this study is to evaluate the role of KRAS and BRAF mutations as prognosis factors and predictive biomarkers for 1st line standard chemotherapy in metastatic colorectal cancer. KRAS mutations and BRAF V600E mutations exhibited a poor outcome (p = 0.021 and p < 0.0001, respectively). Cox multivariate analysis showed that the presence of liver metastasis (HR = 1.595; 95% CI: 1.086–2.343; p = 0.017), KRAS mutation (HR = 1.643; 95% CI: 1.110–2.431; p = 0.013) and BRAF V600E mutation (HR = 5.861; 95% CI: 2.531–13.570; p < 0.0001) were statistically significant co-variables for progression-free survival. Interestingly, patients with KRAS mutations were associated with a poor response to first line standard chemotherapy (p = 0.008). In contrast, the BRAF V600E mutation did not have any impact on the first line standard chemotherapy response (p = 0.540). Therefore, in the present study, we provide new insight on the role of KRAS and BRAF, not only as prognosis biomarkers, but also as first line standard chemotherapy response biomarkers in metastatic colorectal cancer.

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“…Nevertheless, few reports have evaluated tumor sidedness as a risk factor of stage II CC, because many of these reports target advanced stage cancers including metastatic CRC, to analyze the differences in chemotherapy effects. In these advanced stage and metastatic CRCs, molecular and biological differences are considered when selecting a chemotherapy regimen [13,14]. Meanwhile, investigations into the effects of adjuvant chemotherapy on stage II CRC have not yet been concluded; the main problem being that the high-risk factors have not been identi ed.…”

Section: Introductionmentioning

confidence: 99%

Tumor Sidedness Could be a High-risk Factor in Patients with Stage II Colon Cancer

Iguchi¹,

Mushiake²,

Hasegawa³

et al. 2020

Preprint

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Background : The search for high-risk factors in stage II colon cancer (CC) is ongoing and several high-risk factors for stage II CC have been identified; however, the effects of tumor sidedness on prognosis is not clear. This study aims to determine whether tumor sidedness could be identified as another high-risk factor for stage II CC. Methods : We retrospectively analyzed 189 patients with stage II CC, following consecutive curative resection surgery performed between 2008 and 2014. We compared clinicopathological findings and long-term outcomes between the patients with right colonic cancer (RCC) and patients with left colonic cancer (LCC). Prognostic factors for survival were determined using univariate and Cox proportional regression analyses. Results : A total of 72 patients were diagnosed with RCC and 117 patients were diagnosed with LCC. Patients with RCC were significantly older (p < 0.001) than those with LCC, and the number of harvested lymph nodes (HLNs) was greater in the RCC group (RCC: 25 vs. LCC: 19; p = 0.003). The overall survival (OS) was notably worse in the RCC group than the OS in the LCC group (5 year survival rate—RCC: 81.3% vs. LCC: 90.4%; p = 0.025), whereas no significant difference was observed in disease-free survival (5 year survival rate—RCC: 74.8% vs. LCC: 83.4%; p = 0.065). Cox proportional regression analysis showed that tumor sidedness (hazard ratio (HR): 3.78, 95% confidence interval (CI): 1.61–8.85, p = 0.022), gender (HR: 3.27, 95% CI: 1.27–8.47, p = 0.014), and the number of HLNs (HR: 4.58, 95% CI: 1.95–10.74, p < 0.001) were independent prognostic factors for OS. Conclusion : Patients with a right-sided primary tumor location have more negative prognostic factors and worse long-term outcomes than those with a left-sided primary tumor location in stage II CC. Tumor sidedness is a high-risk factor in stage II CC patients.

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Impact of primary tumor location in patients with RAS wild-type metastatic colon cancer treated with first-line chemotherapy plus anti-EGFR or anti-VEGF monoclonal antibodies: a retrospective multicenter study

Cited by 27 publications

References 44 publications

Treatment and Outcomes of Colorectal Cancer in Armenia: A Real-World Experience From a Developing Country

Treatment and Outcomes of Colorectal Cancer in Armenia: A Real-World Experience From a Developing Country

KRAS and BRAF Mutations as Prognostic and Predictive Biomarkers for Standard Chemotherapy Response in Metastatic Colorectal Cancer: A Single Institutional Study

Tumor Sidedness Could be a High-risk Factor in Patients with Stage II Colon Cancer

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