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Patterns of progression, treatment of progressive disease and post-progression survival in the New EPOC study.

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Publication Date
2016-08
ICR Author
Cunningham, David
Author
Pugh, SA
Bowers, M
Ball, A
Falk, S
Finch-Jones, M
Valle, JW
O'Reilly, DA
Siriwardena, AK
Hornbuckle, J
Rees, M
Rees, C
Iveson, T
Hickish, T
Maishman, T
Stanton, L
Dixon, E
Corkhill, A
Radford, M
Garden, OJ
Cunningham, D
Maughan, TS
Bridgewater, JA
Primrose, JN
Type
Journal Article
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Abstract
<h4>Background</h4>The addition of cetuximab (CTX) to perioperative chemotherapy (CT) for operable colorectal liver metastases resulted in a shorter progression-free survival. Details of disease progression are described to further inform the primary study outcome.<h4>Methods</h4>A total of 257 KRAS wild-type patients were randomised to CT alone or CT with CTX. Data regarding sites and treatment of progressive disease were obtained for the 109 (CT n=48, CT and CTX n=61) patients with progressive disease at the cut-off date for analysis of November 2012.<h4>Results</h4>The liver was the most frequent site of progression (CT 67% (32/48); CT and CTX 66% (40/61)). A higher proportion of patients in the CT and group had multiple sites of progressive disease (CT 8%, 4/48; CT and CTX 23%, 14/61 P=0.04). Further treatment for progressive disease is known for 84 patients of whom 69 received further CT, most frequently irinotecan based. Twenty-two patients, 11 in each arm, received CTX as a further line agent.<h4>Conclusions</h4>Both the distribution of progressive disease and further treatment are as expected for such a cohort. The pattern of disease progression seen is consistent with failure of systemic micrometastatic disease control rather than failure of local disease control following liver surgery.
URL
https://repository.icr.ac.uk/handle/internal/535
Collections
  • Clinical Studies
Licenseref URL
http://www.rioxx.net/licenses/all-rights-reserved
Version of record
10.1038/bjc.2016.208
Subject
Humans
Colorectal Neoplasms
Liver Neoplasms
Disease Progression
Organoplatinum Compounds
Camptothecin
Leucovorin
Antineoplastic Combined Chemotherapy Protocols
Disease-Free Survival
Neoadjuvant Therapy
Hepatectomy
Aged
Middle Aged
Female
Male
Metastasectomy
Capecitabine
Cetuximab
Irinotecan
Oxaliplatin
Research team
Medicine (RMH Smith Cunningham)
Language
eng
Date accepted
2016-06-13
License start date
2016-08
Citation
British journal of cancer, 2016, 115 (4), pp. 420 - 424

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