Antiangiogenic therapy of metastatic colorectal carcinoma - results from two centres colorectal cancer

Konference: 2010 35th Congress ESMO – účast ČR

Kategorie: Kolorektální karcinom

Téma: Colorectal Cancer

Číslo abstraktu: 0686

Autoři: MUDr. Radka Obermannová; Doc. MUDr. Tomáš Büchler, Ph.D.; Mgr. Michal Štícha; MUDr. Jiří Navrátil; MUDr. Martin Foldyna; MUDr. Jana Čejková (dříve Kaňáková); MUDr. Lenka Baldíková (Slámová); prof. MUDr. Rostislav Vyzula, CSc.; prof. MUDr. Jitka Abrahámová, DrSc.

Background: Antiangiogenic treatment with bevacizumab is a part of standard systemic therapy for metastatic colorectal cancer (mCRC). In a retrospective study, we have analysed the outcomes of therapy and prognostic/predictive factors in patients (pts) treated in two Czech cancer centres.

Patients and methods: The cohort included 238 consecutive pts treated with bevacizumab for mCRC at the Masaryk Memorial Cancer Institute and at the Thomayer University Hospital, Czech Republic. The following potential prognostic/predictive factors were evaluated: age, gender, tumour grade, number of metastatic sites, associated chemotherapy regimen, presence/absence of KRAS mutation, and preexisting or therapy-induced hypertension.

Results: Median age of pts treated with bevacizumab as a part of first-line systemic therapy was 60 years. The progression-free survival (PFS) and overall survival (OS) were 11.3 months and 30.6 months, respectively. ORR was 45.6% with 12% CRs and disease stabilisation occurred in 29% of pts. Higher grade and/or number of metastatic sites were adversely associated with both PFS and OS. KRAS was not predictive of PFS but was a strong favourable prognostic factor for OS due to the possibility of subsequent therapy with cetuximab (43.8 vs. 27.5 months, p=0.015). Toxicity profile was as expected but thromboembolic events occurred in as many as 11% of pts 65 years or older. Preexisting or de novo hypertension was not associated with treatment outcomes.

Conclusions: Outcomes of ´real-life´ pts with mCRC are comparable to those achieved in clinical trials. Thromboembolism emerges as the most significant toxicity in elderly mCRC pts treated with bevacizumab. Sequential targeted therapy improves survival in mCRC but is currently an option only for pts with KRAS wt tumours.

Disclosure: T. Buchler: Speakers honoraria from Bayer and Novartis

All other authors have declared no conflicts of interest.

Datum přednesení příspěvku: 9. 9. 2010