Late-line mCRC: bulk tied to poorer anti-EGFR outcomes

  • Kratz JD & al.
  • J Natl Compr Canc Netw
  • 1 Dec 2018

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Metastatic tumor bulk and right-sidedness of the primary tumor are tied to poorer OS with late-line anti-epidermal growth factor receptor (EGFR) therapy for metastatic colorectal cancer (mCRC).
  • Patients with right-sided primary tumors presented with increased tumor bulk.

Why this matters

  • Future studies should examine metastatic tumor bulk alongside molecular profiling to help determine which patients may benefit from late-line anti-EGFR therapy.

Study design

  • Retrospective, single-center analysis of 62 KRAS wild-type patients with mCRC treated with late-line anti-EGFR therapy.
  • Funding: National Cancer Institute.

Key results

  • 15 of 47 tumors were right-sided. Right-sided patients were older (mean, 69 vs 59 years; P=.04) and had larger metastases (mean largest diameter, 52.7 vs 28.5 mm; P=.03) and worse OS (6.8 vs 16.7 months; P=.047).
  • After correction for primary tumor location, bulky disease (defined as any single lesion ≥35 mm in longest cross-sectional diameter or nodal short axis), was associated with:
    • Worse survival with anti-EGFR therapy (6.0 months vs 16.0 months; P=.006).
    • Worse PFS (3.5 vs 7.2 months; P=.001).
    • Worse objective response rate (9.5% vs 38.7%; P=.044).
    • Worse OS (6.0 vs 23.4 months; P<.001>

Limitations

  • Retrospective, single-center.

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