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|Title:||Impact of primary tumour site on Bevacizumab efficacy in metastatic colorectal cancer.|
|Epworth Authors:||Zimet, Allan|
|Other Authors:||Wong, Hui-li|
Metastatic Colorectal Cancer
Department of Oncology, Epworth Hospital, Richmond, Victoria, Australia
Cancer Services Clinical Institute, Epworth HealthCare, Victoria, Australia
|Citation:||Clinical Colorectal Cancer. 2016 Feb 13. pii: S1533-0028(16)30019-6|
|Abstract:||BACKGROUND: With an ever-increasing focus on personalized medicine, all factors known to affect treatment response need to be considered when defining optimal therapy for individual patients. While the prognostic impact of primary tumor site on colorectal cancer (CRC) outcomes is established, emerging data suggest potential differences in response to biologic therapies. We studied the impact of tumor site on bevacizumab efficacy in patients with metastatic CRC. PATIENTS AND METHODS: We analyzed data of patients in an Australian prospective multicenter metastatic CRC (mCRC) registry who received first-line chemotherapy. Tumor site was defined as right colon, cecum to transverse; left colon, splenic flexure to rectosigmoid; and rectum. Kaplan-Meier and Cox models were used for survival analyses. RESULTS: Of 926 patients, 297 had right colon, 354 left colon, and 275 rectum primary disease. Median age was 68.6, 65.9, and 63.3 years, respectively (P = .001). Right colon disease was significantly associated with intraperitoneal spread (P < .0001), while left colon and rectum disease preferentially metastasized to the liver and lungs, respectively (P < .0001 in both settings). A total of 636 patients (68.7%) received bevacizumab. Progression-free survival was superior for bevacizumab-treated patients in all groups but appeared greatest in right colon disease (hazard ratio, 0.46; 95% confidence interval, 0.36-0.60; P ≤ .001). Overall survival was longest in patients with disease of the rectum, followed by left colon and right colon (median, 26.2, 23.6, and 18.2 months, respectively; P = .0004). CONCLUSION: Tumor site appears to be prognostic in mCRC, with rectum and right colon disease associated with the best and worst outcomes, respectively. Patients who received bevacizumab in addition to chemotherapy had superior outcomes, with the effect appearing greatest in patients with right colon disease.|
|Journal Title:||Clinical Colorectal Cancer|
|Affiliated Organisations:||Systems Biology and Personalised Medicine Division, Walter & Eliza Hall Institute of Medical Research (WEHI), Parkville, Melbourne, Victoria, Australia.|
Department of Medical Oncology, The Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia.
Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
Eastern Health, Department of Medical Oncology, Melbourne, Victoria, Australia.
Department of Health Education and Research, Melbourne EpiCentre, The Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia.
Cabrini Health, Department of Oncology, Malvern, Melbourne, Victoria, Australia.
Department of Medicine, Nursing & Health Sciences, Monash University, Parkville, Melbourne, Victoria, Australia.
Western Health, Department of Medical Oncology, Footscray, Melbourne, Victoria, Australia.
Department of Medical Oncology, Canberra and Calvary Hospitals, Garran, Australian Capital Territory, Australia.
Department of Medical Oncology, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Department of Oncology, Ringwood Private Hospital, Ringwood East, Victoria, Australia.
|Type of Clinical Study or Trial:||Prospective Cohort Study|
|Appears in Collections:||Cancer Services|
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