Primary tumor sidedness and benefit from FOLFOXIRI plus bevacizumab as initial therapy for metastatic colorectal cancer. Retrospective analysis of the TRIBE trial by GONO

Cremolini, Chiara; Antoniotti, Carlotta; Lonardi, Sara; Bergamo, Francesca; Cortesi, Enrico; Tomasello, Gianluca; Moretto, Roberto; Ronzoni, Monica; Racca, Patrizia; Loupakis, Fotios; Zaniboni, Alberto; Tonini, Giuseppe; Buonadonna, Angela; Marmorino, Federica; Allegrini, Giacomo; Granetto, Cristina; Masi, Gianluca; Zagonel, Vittorina; Sensi, Elisa; Fontanini, Gabriella; Boni, Luca; Falcone, Alfredo

doi:10.1093/annonc/mdy140

Cited by 88 publications

(75 citation statements)

References 12 publications

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“…22 Similar to the experience seen in liver resection [24][25][26] and palliative chemotherapy, 27 right-sided tumors were associated with an inferior outcome, with no patient surviving 5 years. 22 Similar to the experience seen in liver resection [24][25][26] and palliative chemotherapy, 27 right-sided tumors were associated with an inferior outcome, with no patient surviving 5 years.…”

Section: Discussionmentioning

confidence: 73%

“…Because recurrence alone is not predictive of short survival, DFS is not an appropriate outcome parameter with which to assess the efficacy of LT in CRLM. 22 Similar to the experience seen in liver resection [24][25][26] and palliative chemotherapy, 27 right-sided tumors were associated with an inferior outcome, with no patient surviving 5 years. Thus, caution is probably warranted in offering these patients LT ( Figure 4B).…”

Section: Discussionmentioning

confidence: 73%

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Selection criteria related to long-term survival following liver transplantation for colorectal liver metastasis

Dueland

Grut

Syversveen

et al. 2020

American Journal of Transplantation

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Patients with nonresectable colorectal cancer receiving palliative chemotherapy have a 5-year overall survival rate of about 10%. Liver transplant provided a Kaplan-Meier-estimated 5-year overall survival of up to 83%. The objective of the study was to evaluate the ability of different scoring systems to predict long-term overall survival after liver transplant. Patients with colorectal cancer with nonresectable liveronly metastases determined by computed tomography (CT)/magnetic resonance imaging/positron emission tomography (PET)-CT scans from 2 prospective studies (SECA-I and -II) were included. All included patients had previously received chemotherapy. PET-CT was performed within 90 days of the liver transplant. Overall survival, disease-free survival, and survival after relapse based on the Fong Clinical Risk Score, total PET liver uptake (metabolic tumor volume), and Oslo Score were compared. At median follow-up of 85 months for live patients, Kaplan-Meier overall survival rates at 5 years were 100%, 78%, and 67% in patients with Fong Clinical Risk Score 0 to 2, metabolic tumor volume-low group, and Oslo Score 0 to 2, respectively. Median overall survival was 101, 68, and 65 months in patients with Fong ClinicalRisk Score 0 to 2, metabolic tumor volume-low, and Oslo Score 0 to 2. These selection criteria may be used to obtain 5-year overall survival rates comparable to other indications for liver transplant. K E Y W O R D Scancer/malignancy/neoplasia, cancer/malignancy/neoplasia: metastatic disease, clinical research/practice, clinical trial, liver disease: malignant, liver transplantation/hepatology

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 73%

Selection criteria related to long-term survival following liver transplantation for colorectal liver metastasis

Dueland

Grut

Syversveen

et al. 2020

American Journal of Transplantation

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“…2,4 There are several explanations for the differences in prognosis between primary tumor locations: (1) poorer response to systemic therapy of patients with RCC patients compared with patients with LCC; (2) higher frequency of signet-ring cell carcinoma and mucinous adenocarcinoma in RCC, which are associated with worse outcome; and (3) differences in metastatic patterns, which might influence survival as well. [5][6][7][8][9][10] The purpose of this study was to explore the differences in survival between primary tumor location in mCRC, hereby focusing on the role of metastatic sites using data from the Netherlands Cancer Registry.…”

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confidence: 99%

The Impact of Primary Tumor Location in Synchronous Metastatic Colorectal Cancer: Differences in Metastatic Sites and Survival

et al. 2019

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Purpose. We explored differences in survival between primary tumor locations, hereby focusing on the role of metastatic sites in synchronous metastatic colorectal cancer (mCRC). Methods. Data for patients diagnosed with synchronous mCRC between 1989 and 2014 were retrieved from the Netherlands Cancer registry. Relative survival and relative excess risks (RER) were analyzed by primary tumor location (right colon (RCC), left colon (LCC), and rectum). Metastatic sites were reported per primary tumor location. Survival was analyzed for metastatic sites combined and for single metastatic sites. Results. In total, 36,297 patients were included in this study. Metastatic sites differed significantly between primary tumor locations, with liver-only metastases in 43%, 54%, and 52% of RCC, LCC, and rectal cancer patients respectively (p \ 0.001). Peritoneal metastases were most prevalent in RCC patients (33%), and lung metastases were most prevalent in rectal cancer patients (28%). Regardless of the location of metastases, patients with RCC had a worse survival compared with LCC (RER 0.81, 95% CI 0.78-0.83) and rectal cancer (RER 0.73, 95% CI 0.71-0.76). The survival disadvantage for RCC remained present, even in cases with metastasectomy for liver-only disease (LCC: RER 0.66, 95% CI 0.57-0.76; rectal cancer: RER 0.84, 95% CI 0.66-1.06).Conclusions. This study showed significant differences in relative survival between primary tumor locations in synchronous mCRC, which can only be partially explained by distinct metastatic sites. Our findings support the concept that RCC, LCC and rectal cancer should be considered distinct entities in synchronous mCRC.

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“…29 In retrospective analyses of the TRIBE trial, triplet chemotherapy plus bevacizumab improved ETS and DpR compared to doublet chemotherapy plus bevacizumab and provided survival benefits to patients with right-versus left-sided tumors independent of their RAS and BRAF status. 15,22 Improved efficacy was also observed with FOLFOXIRI plus bevacizumab versus FOLFOX plus bevacizumab in analyses of the STEAM trial. 30 It is therefore possible that a more intensive chemotherapy regimen, by inducing tumor shrinkage, may reduce tumor-related symptoms in patients with mCRC, including those with right-sided or RAS-/ BRAF-mutated tumors.…”

Section: Discussionmentioning

confidence: 94%

“…Left-sided tumors are more common and are associated with a better prognosis and increased response to anti-EGFR treatment. [20][21][22] First-line panitumumab treatment has been associated with improved ETS and DpR compared to comparator treatments in patients with left-sided disease. 21 Further to this, existence of ETS !…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Tumor Response and Tumor-Related Symptoms in RAS Wild-Type Metastatic Colorectal Cancer: Retrospective Analyses From 3 Panitumumab Trials

Taieb

Geißler

Rivera

et al. 2019

Clinical Colorectal Cancer

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Tumor-related symptoms can affect treatment choices in metastatic colorectal cancer (mCRC). In the current study, 659 patients with RAS wild-type mCRC were retrospectively analyzed to evaluate the relationship between tumor shrinkage and the time to onset of tumor-related symptoms. Symptom onset was delayed in patients with earlier and greater tumor shrinkage. Therefore, treatments that facilitate cytoreduction may delay symptom development. Background: There is no standardized assessment of symptomatic events in metastatic colorectal cancer (mCRC) despite disease symptoms that affect treatment decisions. Data from 3 first-line panitumumab in mCRC trials were retrospectively analyzed to assess whether early tumor shrinkage (ETS) and depth of response (DpR) were associated with time to occurrence of tumor-related symptoms. Patients and Methods: Patients with RAS wild-type mCRC from PRIME, PEAK, and Study 314 were included. ETS was defined as a reduction of ! 30% in the sum of the longest diameters of lesions at 8 weeks. DpR was calculated as maximum percentage change in tumor size from baseline to nadir. The proportion of patients who developed symptoms (including a composite symptomatic endpoint) during study treatment was calculated. This study was registered at ClinicalTrials.gov as PRIME (NCT00364013), PEAK (NCT00819780), and Study 314 (NCT00508404). Results: Overall, data of 659 patients were analyzed. Onset of symptoms was delayed in patients with ETS ! 30% versus ETS < 30% and in patients with greater DpR. In patients with symptoms at baseline who experienced ETS ! 30%, overall survival was similar to that seen for patients without symptoms at baseline. Conclusion: Both ETS and DpR were associated with delayed onset of symptoms in RAS wildtype mCRC patients. Treatments with high cytoreductive potential may delay symptom development.

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Primary tumor sidedness and benefit from FOLFOXIRI plus bevacizumab as initial therapy for metastatic colorectal cancer. Retrospective analysis of the TRIBE trial by GONO

Abstract: FOLFOXIRI plus bevacizumab may be regarded as a preferred first-line treatment option for clinically selected patients with right-sided metastatic colorectal cancer irrespective of their RAS and BRAF mutational status. Trial registration: clinicaltrials.gov identifier NCT00719797.

Cited by 88 publications

References 12 publications

Selection criteria related to long-term survival following liver transplantation for colorectal liver metastasis

Selection criteria related to long-term survival following liver transplantation for colorectal liver metastasis

The Impact of Primary Tumor Location in Synchronous Metastatic Colorectal Cancer: Differences in Metastatic Sites and Survival

Relationship Between Tumor Response and Tumor-Related Symptoms in RAS Wild-Type Metastatic Colorectal Cancer: Retrospective Analyses From 3 Panitumumab Trials

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