Early onset metastatic colorectal cancer in patients receiving panitumumab-based upfront strategy: Overall and sex-specific outcomes in the Valentino trial

被引：9

作者：

Raimondi, Alessandra ^{[1
]}

Randon, Giovanni ^{[1
]}

Prisciandaro, Michele ^{[1
,2
]}

Pagani, Filippo ^{[1
]}

Lonardi, Sara ^{[3
]}

Antoniotti, Carlotta ^{[4
]}

Bozzarelli, Silvia ^{[5
]}

Sartore-Bianchi, Andrea ^{[2
,6
]}

Tampellini, Marco ^{[7
]}

Fanchini, Laura ^{[8
]}

Murialdo, Roberto ^{[9
,10
]}

Clavarezza, Matteo ^{[11
]}

Zaniboni, Alberto ^{[12
]}

Berenato, Rosa ^{[13
]}

Ratti, Margherita ^{[14
]}

Petrelli, Fausto ^{[15
]}

Antonuzzo, Lorenzo ^{[16
,17
]}

Giordano, Monica ^{[18
]}

Rossi, Alessandro ^{[19
]}

Di Bartolomeo, Maria ^{[1
]}

Di Maio, Massimo ^{[20
]}

Pietrantonio, Filippo ^{[1
]}

Morano, Federica ^{[1
]}

机构：

[1] Fdn IRCCS Ist Nazl Tumori, Dept Med Oncol, Via Giacomo Venezian 1, I-20133 Milan, Italy

[2] Univ Milan, Oncol & Hematooncol Dept, Milan, Italy

[3] Veneto Inst Oncol IRCCS, Dept Oncol, Padua, Italy

[4] Azienda Osped Univ Pisana, Unit Med Oncol, Pisa, Italy

[5] IRCCS Humanitas Res Hosp, Humanitas Canc Ctr, Med Oncol & Hematol Unit, Rozzano, Italy

[6] Grande Osped Metropolitano Niguarda, Div Oncol, Milan, Italy

[7] Univ Torino, Dept Oncol, AOU San Luigi di Orbassano, Orbassano, Italy

[8] AOU Citta Salute & Sci Torino, Dipartimento Oncol, SSD ColoRectal Canc Unit, Turin, Italy

[9] Univ Genoa, Dept Internal Med, Genoa, Italy

[10] IRCCS AOU San Martino IST, Genoa, Italy

[11] Ente Osped Osped Galliera, Med Oncol Unit, Genoa, Italy

[12] Fdn Poliambulanza, Med Oncol Unit, Brescia, Italy

[13] AO Papardo, Med Oncol Unit, Messina, Italy

[14] ASST Osped Cremona, Med Oncol Unit, Cremona, Italy

[15] ASST Bergamo Ovest, Med Oncol Unit, Oncol Dept, Treviglio, Italy

[16] AOU Careggi, Clin Oncol Unit, Florence, Italy

[17] Univ Florence, Dept Expt & Clin Med, Florence, Italy

[18] Azienda Socio Sanitaria Terr Lariana, Med Oncol Unit, Como, Italy

[19] Univ Roma La Sapienza, Dept Clin & Mol Med, Oncol Unit, Azienda Osped St Andrea, Rome, Italy

[20] Univ Turin, Ordine Mauriziano Hosp, Dept Oncol, Div Med Oncol, Turin, Italy

来源：

INTERNATIONAL JOURNAL OF CANCER | 2022年 / 151卷 / 10期

关键词：

age; colorectal cancer; early-onset colorectal cancer; EGFR inhibitor; metastasis; CLINICAL-PRACTICE GUIDELINES; 1ST-LINE TREATMENT; COLON-CANCER; RISK-FACTORS; YOUNG AGE; SURVIVAL; ADOLESCENTS; CARCINOMA; CETUXIMAB; IMPACT;

D O I：

10.1002/ijc.34156

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Anti-EGFRs plus doublet chemotherapy is considered the optimal upfront option for RAS/BRAF wild-type left-sided metastatic colorectal cancer (mCRC). Early-onset (EO) mCRC has an increasing incidence and its prognostic/predictive role and management is debatable. We performed a post hoc analysis of Valentino study, that randomized RAS wild-type mCRC patients to two panitumumab-based maintenance regimens after FOLFOX/panitumumab induction. We assessed the safety and efficacy outcomes in patients stratified for age (<50/>= 50 years old). We assessed progression-free survival (PFS), overall survival (OS), response rate (ORR), rate of treatment-related and panitumumab-related adverse events (AEs) and quality of life (QoL). In 229 patients enrolled, 35 (15%) had EO mCRC, with a higher rate of female sex (P = .020) and lower rate of primary tumor resection (P = .001). Median PFS and OS were 10.9 vs 10.8 months (P = .593) and 28.1 vs 27.5 months (P = .865) in patients <50 and >= 50 years old, respectively, with no significant impact of maintenance arm. ORR and disease control rate were 74% vs 65% (P = .337) and 97% vs 81% (P = .013) in patients <50 or >= 50 years old. In younger patients, a trend for increased chemotherapy-related AEs (peculiarly anemia) was shown, while significantly decreased EGFR-related hypomagnesemia and increased skin rash were reported. No significant differences in treatment intensity or QoL were observed. In patients with EO mCRC and RAS wild-type status, we found no differences in terms of survival outcomes based on age when selecting maintenance strategies. Management of treatment-related AEs should consider the differential toxicity profile of age and sex.

引用

页码：1760 / 1769

页数：10

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