Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2018 ASCO Annual Meeting but not presented at the Meeting, can be found online only.
Implications of KRAS status in first line chemotherapy with bevacizumab in advanced colorectal cancer: A phase IV study of Hellenic Oncology Research Group (HORG).
Gastrointestinal (Colorectal) Cancer
2018 ASCO Annual Meeting
J Clin Oncol 36, 2018 (suppl; abstr e15521)
Author(s): Anna Koumarianou, Nikolaos Ziras, Stylianos Kakolyris, Michael Vaslamatzis, Aristidis Polyzos, Nikolaos K. Kentepozidis, Athina Christopoulou, Spyros Xynogalos, Athanasios Athanasiadis, Ilias Athanasiadis, Athanasios Anagnostopoulos, Athanasios Karampeazis, Christos E. Emmanouilides, Ioannis Boukovinas, Paris Makrantonakis, Charalambos Kouroussis, Efthimios Prinarakis, Dora Hatzidaki, Vassilis Georgoulias; Hellenic Oncology Research Group (HORG), Athens, Greece; Hellenic Oncology Research Group (HORG), Athens, AZ, Greece
Background: Bevacizumab (BEV) is an active antiangiogenic agent for the treatment of all patients (pts) with advanced colorectal cancer (CRC). We investigated the toxicity, compliance and survival of pts with locally advanced/inoperable or metastatic CRC treated with BEV-based treatment according to KRAS status. Methods: This phase IV study recorded prospectively (July 2009-June 2016) the clinicopathologic characteristics, safety and survival of pts receiving BEV with 1st line chemotherapy according to oncologist’s preference. Results: Of 682 pts providing consent for BEV-based therapy, 382pts completed treatment; 144pts had disease progression and 156pts discontinued treatment (adverse events: 58pts; toxic deaths: 2pts; consent withdrawn: 34pts; lost to follow up: 5pts; other reasons: 33pts whereas 24pts underwent curative metastasectomy/surgery). On treatment initiation KRAS status was recorded as mutant (mtKRAS) in 229pts (33.65%), wild type (wtKRAS) in 177pts (26%) and unknown (uKRAS) in 276pts (40.5%). Chemotherapy regimens included FOLFOX (243pts; 37%), FOLFIRI (197pts; 30%), XELOX (147pts; 22.5%) and XELIRI (69pts; 10.5%). The median follow up was 34.9m (0.4–66.3), the mPFS of the entire cohort was 10.8m (0.4-66.3) [mtKRAS 11.0m (1.0-55.7), wtKRAS 9.7m (0.9-61.9), uKRAS 11.3m (0.4-66.3); p = 0.033 (all three), p = 0.051 (mt vs u), p = 0.020 (wt vs u)] and the mOS was 26.4m (0.4-66.3) [mtKRAS 25.6m (1.4-61.3), wtKRAS 25.2m (2.2-63.7) and uKRAS 28.1m (1.4-66.3); p = 0.796 (all three)]. The ORR (CR+PR) in evaluable pts was 46.6% (104pts) in mtKRAS, 56.1% (97pt) in wtKRAS and 40.9% (112pt) in uKRAS [p = 0.007 (all three); p = 0.063 (mt vs wt); p = 0.002 (wt vs u)]. The ORR for FOLFOX/BEV was 48.3% (115pts), FOLFIRI/BEV 47.7% (92pts) and XELOX/BEV 45% (65pts) regardless the KRAS status. Toxicity profile was similar to previous BEV-investigating studies. BEV-related SAEs were myocardial infarction (1pt; G5), ileus (2pts; G4) and thromboembolism (8pts; G4). Conclusions: This phase IV study adds on evidence that BEV-based front line therapy is highly efficacious in pts with advanced CRC independently of mutant, wild or unknown KRAS status. Clinical trial information: NCT01811108