Report from the 19th Annual Western Canadian Gastrointestinal Cancer Consensus Conference; Winnipeg, Manitoba; 29–30 September 2017

Kim, Christina; Ahmed, Shahid; Brunet, Bryan; Chalchal, Haji; Deobald, Raymond G.; Doll, Corinne; Mp, Dupre; Гордон,; Rm, Lee-Ying; Lim, Hyeon‐Sook; D, Liu; Loree, Jonathan M.; Jp, McGhie; Mulder, Karen; Park, J; Yip, Bak-Sau; Rp, Wong; Zaidi, Adnan

doi:10.3747/co.25.4109

Cited by 1 publication

(1 citation statement)

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“…Post hoc retrospective analysis of pivotal trials and several meta-analyses have demonstrated overall survival (OS) improvements with the addition of EGFR inhibitors to chemotherapy versus chemotherapy +/− bevacizumab in patients with 1L RAS wild-type (WT) left-sided mCRC [ 12 , 13 , 14 , 15 , 16 ]. As such, clinical and molecular markers including PTL should be taken into consideration to guide treatment decisions related to 1L mCRC, as recommended by clinical practice guidelines [ 17 , 18 ] and several Canadian consensus papers [ 19 , 20 , 21 , 22 , 23 ]. The randomized controlled phase 3 PARADIGM study prospectively demonstrated that panitumumab added to mFOLFOX6 led to a median OS benefit of 3.6 months in the left-sided population over bevacizumab plus mFOLFOX6 [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Real-World Study to Assess Patterns of Treatment Practices and Clinical Outcomes in Metastatic Colorectal Cancer Patients with RAS Wild-Type Left-Sided Tumours in Canada

Boyne,

Ngan,

Carbonell

et al. 2023

Current Oncology

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Minimal Canadian data are available on the RAS testing rates, treatment patterns, and corresponding overall survival (OS) in metastatic colorectal cancer (mCRC) patients. We conducted a population-based cohort study of left-sided RAS wild-type (WT) mCRC patients diagnosed between 1 January 2014 and 31 December 2019, and who were treated with first-line (1L) chemotherapy plus the epidermal growth factor receptor inhibitor panitumumab, chemotherapy plus bevacizumab, or chemotherapy alone, in Alberta, Canada, using electronic medical records and administrative health system data. Of the 2721 patients identified with left-sided mCRC, 320 patients with RAS WT mCRC were treated with 1L systemic therapy: chemotherapy plus panitumumab (n = 64), chemotherapy plus bevacizumab (n = 52), or chemotherapy alone (n = 204). Only 65% and 39% of the 320 1L-treated patients initiated second- and third-line therapy, respectively. A total of 71% of individuals with treated left-sided mCRC underwent RAS testing. The median OS for mCRC patients with RAS WT left-sided tumours was higher for patients treated with 1L panitumumab plus chemotherapy (34.3 months; 95% CI: 23.8–39.6) than for patients who received 1L chemotherapy alone (30.0 months; 95% CI: 24.9–34.1) or 1L bevacizumab plus chemotherapy (25.6 months; 95% CI: 21.2–35.7). These findings highlight an unmet need in left-sided RAS WT mCRC, with relatively few individuals receiving a biologic agent in combination with chemotherapy in the 1L setting, a high rate of attrition between lines, and a need for increased RAS testing before treatment initiation.

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