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Personalized therapy for metastatic colorectal cancer in Colombia (ONCOLGroup).
Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^).
Background: Targeted therapies have improved the survival of patients with metastatic colorectal cancer (mCRC). Data about expression of EGFR, KRAS, NRAS, and BRAF mutation status, and PI3K/PTEN expression improved patient selection for targeted treatments. Methods: This study included 202 patients with mCRC who were treated at the Fundación Santa Fe de Bogotá (FSFB) from March 2009 to March 2013. The overall response rate (ORR), clinical benefit (CB), progression free survival (PFS) and overall survival (OS) were estimated. The OS was analysed according to KRAS, BRAF and PI3K mutational profile. Results: Median age was 58,5-yo (+/- 9.7); 88% on included pts had ECOG 0-1 and dominant metastatic sites were the liver (53.5%), regional lymph nodes (15.3%), lungs (9.4%) and the peritoneum (9.9%). All patients received first line chemotherapy plus some monoclonal antibody (78% involving bevacizumab). ORR was 32.3% and CB reached 76% in the 152 evaluable patients. First line PFS was 7.6-mo (95%CI 4.9-9.2), higher for combinations including bevacizumab compared to cetuximab (7.9 vs. 4.5-mo; p=0.012). The median time for the maintenance following first line treatment (PS1) was 5.9-mo (95%C 3.2-14.2). Median OS was 36 months (95%CI 29.7-42.9), time extended in patients treated with some monoclonal antibody compared to those only receiving conventional chemotherapy (30.5 vs. 25 months; p=0.007) and in KRAS-Wt population (40 vs. 26-mo for KRAS mutants; p=0.028). OS was also higher amongst those receiving second (27.7 months vs. 10.3-mo; p=0.0001) and third line interventions (23 vs.9.7-mo; p=0.06). 32.7% of the tumours harboured a KRAS mutation, 10.9% harboured a PIK3CA mutation, and 6.4% harboured a BRAF mutation. OS for BRAF-Wt population was 30-mo (95%CI 20.1-41.0), whilst those carrying the BRAF mutation lived for 13-mo (95%CI 9.2-17.0; p=0.09). Conclusions: These results agreed with those previously described in the literature. Routine genotyping and its correlation with diverse outcomes in mCRC in Colombia are possible and necessary to improved patient selection for targeted treatments.
Abstracts by Carlos A. Vargas:
- Meeting: 2016 ASCO Annual Meeting | Abstract No: 2059
BIM expression in EGFR-mutant non-small cell lung cancer (NSCLC) patients (pts) treated with erlotinib in Colombia.Meeting: 2014 ASCO Annual Meeting | Abstract No: e19098
- Meeting: 2014 ASCO Annual Meeting | Abstract No: e20054