Differential Efficacy of Targeted Monoclonal Antibodies in Left-Sided Colon and Rectal Metastatic Cancers

IF 3.3 3区医学 Q2 ONCOLOGY Clinical colorectal cancer Pub Date : 2023-09-01 DOI:10.1016/j.clcc.2023.05.002

Hiroyuki Kodama, Toshiki Masuishi, Munehiro Wakabayashi, Akinobu Nakata, Ryosuke Kumanishi, Taiko Nakazawa, Takatsugu Ogata, Yuki Matsubara, Kazunori Honda, Yukiya Narita, Hiroya Taniguchi, Shigenori Kadowaki, Masashi Ando, Kei Muro

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引用次数: 1

Abstract

Background

The recommended first-line chemotherapy for RAS/BRAF wild-type metastatic colorectal cancer (mCRC) is bevacizumab (BEV)-containing therapy for right-sided colon cancer (R) and antiepidermal growth factor receptor antibody (anti-EGFR)-containing therapy for left-sided colon cancer (L) or rectal cancer (RE). However, anatomical or biological heterogeneity reportedly exists between L and RE. Therefore, we aimed to compare the efficacies of anti-EGFR and BEV therapies for L and RE, respectively.

Methods

We retrospectively reviewed 265 patients with KRAS (RAS)/BRAF wild-type mCRC treated with fluoropyrimidine-based doublet chemotherapy plus anti-EGFR or BEV as the first-line treatment at a single institution. They were divided into 3 groups: R, L, and RE. Overall survival (OS), progression-free survival (PFS), objective response rate, and conversion surgery rate were analyzed.

Results

Forty-five patients had R (anti-EGFR/BEV: 6/39), 137 patients had L (45/92), and 83 patients had RE (25/58). In patients with R, both median (m) PFS and OS were superior with BEV therapy (mPFS, anti-EGFR vs. BEV: 8.7 vs. 13.0 months, hazard ratio [HR]: 3.90, P = .01; mOS, 17.1 vs. 33.9 months, HR: 1.54, P = .38). In patients with L, better mPFS and comparable mOS with anti-EGFR therapy were observed (mPFS, 20.0 vs. 13.4 months, HR: 0.68, P = .08; mOS, 44.8 vs. 36.0 months, HR: 0.87, P = .53), whereas, in patients with RE, comparable mPFS and worse mOS with anti-EGFR therapy were observed (mPFS, 17.2 vs. 17.8 months, HR: 1.08, P = .81; mOS, 29.1 vs. 42.2 months, HR: 1.53, P = .17).

Conclusions

Efficacies of anti-EGFR and BEV therapies may differ between patients with L and RE.

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靶向单克隆抗体治疗左半结肠癌和直肠转移癌的疗效差异

背景RAS/BRAF野生型转移性癌症（mCRC）的推荐一线化疗是含有贝伐单抗（BEV）的右半结肠癌癌症（R）治疗和含有抗表皮生长因子受体抗体（抗EGFR）的左半结肠癌癌症（L）或癌症（RE）治疗。然而，据报道，L和RE之间存在解剖或生物学异质性。因此，我们旨在比较抗EGFR和BEV疗法分别对L和RE的疗效。方法我们回顾性分析了265例KRAS（RAS）/BRAF野生型mCRC患者，在单一机构接受基于氟嘧啶的双联化疗加抗EGFR或BEV作为一线治疗。他们被分为3组：R组、L组和RE组。分析总生存率（OS）、无进展生存率（PFS）、客观缓解率和转化手术率。结果45例患者有R（抗EGFR/BEV:6/39），137例患者有L（45/92），83例患者有RE（25/58）。在R患者中，BEV治疗的中位（m）PFS和OS均优于BEV治疗（mPFS，抗EGFR与BEV:8.7vs.13.0个月，危险比[HR]:3.90，P=.01；mOS，17.1vs.33.9个月，HR:1.54，P=.38），而在RE患者中，观察到与抗EGFR治疗相当的mPFS和更差的mPOS（mPFS，17.2对17.8个月，HR:1.08，P=.81；mPOS，29.1对42.2个月，HR：1.53，P=.17）。结论L和RE患者的抗EGFR和BEV治疗效果可能不同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical colorectal cancer 医学-肿瘤学

CiteScore

5.50

自引率

2.90%

发文量

审稿时长

27 days

期刊介绍： Clinical Colorectal Cancer is a peer-reviewed, quarterly journal that publishes original articles describing various aspects of clinical and translational research of gastrointestinal cancers. Clinical Colorectal Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of colorectal, pancreatic, liver, and other gastrointestinal cancers. The main emphasis is on recent scientific developments in all areas related to gastrointestinal cancers. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.