Anti-EGFR antibodies combined with chemotherapy doublets are a cornerstone of the upfront treatment of colorectal cancer. RAS and BRAF mutations are established negative predictive factors for such therapy. The primary tumour located in the proximal colon has recently emerged as another negative predictive factor. We have conducted a retrospective multicentre study to collect data on real-world population characteristics, practice patterns, and outcomes in patients with metastatic colorectal cancer treated in a first-line setting with either cetuximab or panitumumab in combination with either FOLFOX or FOLFIRI chemotherapy. The presented analysis focuses on the impact of the primary tumour location. 126 of 842 patients analysed (15.0%) had proximal primary. It was associated with a lower BMI at diagnosis, mucinous histology, and peritoneal metastases. It was also associated with inferior treatment outcomes in terms of response ratio: 59.4% vs. 74.22% (odds ratio [OR] 0.51, 95% CI 0.33–0.78,p= 0.010), and median depth of response: −36.7% vs. −50.0% (p= 0.038). There was only a borderline non-significant trend for inferior PFS in patients with proximal tumours. OS data was incomplete. The presented analysis confirms the negative impact of tumour sidedness on the efficacy of an upfront anti-EGFR-chemotherapy combination and provides valuable data on real-world population characteristics.
抗EGFR抗体联合双药化疗是结直肠癌一线治疗的基石。RAS和BRAF突变已被确认为该疗法的阴性预测因素。近期研究发现，原发肿瘤位于近端结肠是另一个阴性预测因素。我们开展了一项回顾性多中心研究，旨在收集接受西妥昔单抗或帕尼单抗联合FOLFOX或FOLFIRI方案一线治疗的转移性结直肠癌患者的真实世界人群特征、治疗模式和疗效数据。本分析重点探讨原发肿瘤部位对疗效的影响。在纳入分析的842例患者中，126例（15.0%）原发肿瘤位于近端结肠。近端结肠癌与诊断时较低的身体质量指数、黏液性组织学类型及腹膜转移相关。在治疗反应方面，近端结肠癌患者疗效较差：客观缓解率为59.4%对比74.22%（比值比[OR] 0.51，95%置信区间0.33–0.78，p=0.010），中位缓解深度为-36.7%对比-50.0%（p=0.038）。近端结肠癌患者的无进展生存期仅呈现临界非显著性缩短趋势。总生存期数据尚不完整。本分析证实了肿瘤侧性对一线抗EGFR联合化疗方案疗效的负面影响，并为真实世界人群特征提供了有价值的数据。
肿瘤(癌症)患者之家