1. Biomarker-stratified first-line treatment of right-sided metastatic colon cancer with interdisciplinary collaboration in the IVOPAK II trial.
- Author
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Vitali F, Merkel S, Schubart C, Schmid A, Eckstein M, Stöhr R, Kersting S, Hartmann A, Grützmann R, and Wein A
- Subjects
- Humans, Male, Female, Middle Aged, Aged, Adult, Prospective Studies, Biomarkers, Tumor genetics, Bevacizumab administration & dosage, Bevacizumab therapeutic use, Cetuximab administration & dosage, Cetuximab therapeutic use, Mutation, Survival Rate, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Colonic Neoplasms pathology, Colonic Neoplasms drug therapy, Fluorouracil administration & dosage, Leucovorin administration & dosage, Leucovorin therapeutic use, Camptothecin analogs & derivatives, Camptothecin administration & dosage, Camptothecin therapeutic use
- Abstract
Patients with right-sided metastatic colon carcinoma have a significantly worse prognosis than those with left-sided colorectal cancer (CRC), regardless of treatment. The aim of the prospective IVOPAK II study was to implement an interdisciplinary guideline-conform personalized CRC palliative therapy of metastatic colorectal carcinoma and to improve the overall survival (OS) by multidisciplinary approach via secondary metastatic resection. We present the efficacy data of first-line treatment and the benefit of interdisciplinary collaboration of right-sided metastatic colon carcinoma patients: n = 25. RAS mutation: n = 20 (80%): received systemic first-line treatment: FOLFIRI plus bevacizumab. All-RAS-wildtype: n = 5 (20%): received systemic first-line treatment: FOLFIRI plus cetuximab. Last date evaluation: 31 January 2024. Median age: 59.6 years (range 42-71), men/women: 14/11. Eastern Cooperative Oncology Group (ECOG) index: 0/1/2 : 11/10/4. Evaluable for response: n = 25. Complete response: n = 0, partial response: n = 14 (56%), stable disease: n = 8 (32%), progressive disease: n = 3 (12%), early tumor shrinkage: n = 13 (52%), estimates progression-free survival: 13 months (95% CI 8-17 months), estimated OS: 48 months (95% CI 25-71 months), median follow-up: 26 months (1-61 months), no evidence of disease: n = 4 (16%). A chemotherapy doublette regimen with FOLFIRI plus a biological as first-line treatment shows promising efficacy and secondary metastatic resection after interdisciplinary discussion was associated with a survival benefit in right-sided metastatic colon carcinoma., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2024
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