CRC liver metastases: postchemotherapy resection extends OS

  • Yasuno M & al.
  • Int J Clin Oncol
  • 5 Jan 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • In patients with colorectal cancer with liver-only metastases that were unsuitable for upfront resection, pretreatment with modified oxaliplatin-infused 5-fluorouracil leucovorin (mFOLFOX6) plus bevacizumab (BV) followed by resection led to better survival than chemotherapy alone.
  • Most patients in both groups developed recurrences.

Why this matters

  • The results represent the final survival analysis of the TRICC0808 phase 2 study after 3-year follow-up.

Study design

  • 45 patients from 25 institutions underwent 6 cycles of mFOLFOX6+BV therapy; 31 subsequently underwent hepatectomy.
  • Funding: Tokyo Medical and Dental University; Foundation for Biomedical Research and Innovation.

Key results

  • Previously, researchers reported an R0 resection rate of 44.4% in patients receiving mFOLFOX6+BV.
  • Overall OS:
    • 1 year: 91.1% (95% CI, 78.0%-96.0%).
    • 2 years: 68.9% (95% CI, 53.2%-80.2%).
    • 3 years: 44.0% (95% CI, 29.2%-57.8%).
  • Mean survival time (MST) was 33.6 months.
  • 3-year OS with hepatectomy: 61.3% (95% CI, 42.0%-75.8%; MST, 43.1 months).
  • 3-year OS without hepatectomy: 0% (MST, 21.0 months; P<.0001>
  • In patients who underwent hepatectomy after 6 cycles of chemotherapy, 3-year relapse-free survival was 8.3% (MST, 36.8 months).

Limitations

  • Small sample size.