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Title: Clinicopathological differences and survival outcomes with first-line therapy in patients with left-sided colon cancer and rectal cancer: Pooled analysis of 2879 patients from AGITG (MAX), COIN, FOCUS2, OPUS, CRYSTAL and COIN-B trials in the ARCAD database.
Austin Authors: Salem, Mohamed E;Yin, Jun;Weinberg, Benjamin A;Renfro, Lindsay A;Pederson, Levi D;Maughan, Timothy S;Adams, Richard A;Van Cutsem, Eric;Falcone, Alfredo;Tebbutt, Niall C ;Seymour, Matthew T;Díaz-Rubio, Eduardo;Aranda, Enrique;Bokemeyer, Carsten;Heinemann, Volker;Wasan, Harpreet;de Gramont, Aimery;Grothey, Axel;Shi, Qian;Sargent, Daniel J;Marshall, John L
Affiliation: Medical Oncology, West Cancer Center, Germantown, TN, USA
Imperial College Healthcare NHS Trust, London, UK
Department of Medical Oncology, Franco-British Institute, Levallois-Perret, France
Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC, USA
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
CRUK/MRC Oxford Institute for Radiation Oncology, Oxford, UK
Cardiff University, Cardiff, UK
Digestive Oncology, University Hospitals Leuven and KU Leuven, Leuven, Belgium
Department of Oncology, University of Pisa, Pisa, Italy
Department of Medical Oncology, Austin Health, Heidelberg, Victoria, Australia
Gastrointestinal Cancer Research Unit, Cookridge Hospital, Leeds, UK
Department Oncology, Hospital Clínico San Carlos, CIBERONC, Madrid, Spain
Reina Sofia Hospital, University of Cordoba, Maimonides Institute of Biomedical Research, CIBERONC, Avenida de Menendez Pidal, Cordoba, Spain
Department of Oncology, Haematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Comprehensive Cancer Center, Ludwig-Maximilians-University of Munich, Munich, Germany
Issue Date: Nov-2018
Date: 2018-09-27
Publication information: European journal of cancer (Oxford, England : 1990) 2018; 103: 205-213
Abstract: Patients with left-sided colon tumours have better survival and respond differently to biologics compared with patients with right-sided tumours. Left-sided colon tumours and rectal cancers are often grouped together. Herein, we examined the clinicopathological differences and outcomes between left-sided colon and rectal cancers. Data from 2879 metastatic colorectal cancer patients enrolled on six first-line clinical trials during 2004-2010 were pooled. Patients were included if the primary tumour origin was clearly defined. Progression-free survival (PFS) and overall survival (OS) were compared in the two groups after adjusting for patient and tumour characteristics, metastatic sites and the first-line regimen. In total, 1374 patients with metastatic left-sided colon cancer and 1505 patients with metastatic rectal cancers were evaluated. Left-sided colon cancer patients were more likely to be female (40.1% versus 32.6%; P < 0.0001) and older (31.0% ≥ 70 years versus 25.8%; P = 0.0033) compared with rectal cancers patients. Patients with left-sided colon cancer had higher rates of liver metastases (80.9% versus 72.3%, P < 0.0001) but lower rates of lung metastases (34.2% versus 53.8%, P < 0.0001). KRAS mutations were slightly less frequent among left-sided tumours (34.8% versus 40.5%; P = 0.0103). Patients with left-sided tumours had approximately similar PFS (median 7.4 versus 6.9 months; hazard ratio [HR] 0.92, 95% confidence interval [CI] 0.87-1.03; P = 0.1998) and OS (median 17.4 versus 16.6 months; HR 0.99, 95% CI 0.91-1.07; P = 0.7597) compared with rectal cancer patients. The site of tumour origin within the left side was not prognostic of outcomes. Moreover, neither bevacizumab nor cetuximab impacted, differently, the findings of the comparisons in outcomes between patients with left-sided colon tumours or rectal cancers.
DOI: 10.1016/j.ejca.2018.08.020
Journal: European journal of cancer (Oxford, England : 1990)
PubMed URL: 30268921
Type: Journal Article
Subjects: Bevacizumab
Left-sided colon cancer
Rectal cancer
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