Real-World Outcomes in Patients with Metastatic Colorectal Cancer in Spain: The RWD-ACROSS Study

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2023 Sep 28

PMID 37760572

Authors

Carles Pericay

Ana Fernandez Montes

Vicente Alonso Orduna

Ismael Macias Declara

Elena Asensio Martinez

Nuria Rodriguez Salas

Esperanza Torres

Diego Cacho Lavin

Rosa Maria Rodriguez Alonso

Esther Falco

Joan Carles Oliva

Lluis Cirera

Affiliations

Soon will be listed here.

Abstract

The retrospective, observational RWD-ACROSS study analyzed disease characteristics, systemic treatment, and survival in patients with metastatic colorectal cancer (mCRC) in Spain. In total, 2002 patients were enrolled (mean age 65.3 years; 62.7% male). Overall median overall survival (OS) was 26.72 months, and was longer in patients with left-sided tumors (28.85 vs. 21.04 months (right-sided tumors); 0.0001) and in patients receiving first-line anti-epidermal growth factor receptor (EGFR) treatment (31.21 vs. 26.75 (anti-vascular endothelial growth factor (VEGF) treatment) and 24.45 months (chemotherapy); 0.002). Overall median progression-free survival (PFS) was 10.72 months and was longer in patients with left-sided tumors (11.24 vs. 9.31 months (right-sided tumors); 0.0001), and in patients receiving either first-line anti-EGFR or anti-VEGF (12.13 and 12.00 vs. 8.98 months (chemotherapy); 0.001). PFS was longer with anti-VEGF treatment in patients with right-sided tumors and wild-type (11.24 vs. 8.78 (anti-EGFR) and 7.83 months (chemotherapy); 0.025). Both anti-EGFR and anti-VEGF produced longer PFS in patients with left-sided tumors and wild-type than chemotherapy alone (12.39 and 13.14 vs. 9.83 months; 0.011). In patients with left-sided tumors and mutant , anti-VEGF produced a longer PFS than chemotherapy alone (12.36 vs. 9.34 months; 0.001). In Spain, wild-type or left-sided mCRC tumors are predictive of longer survival times.

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References

Parikh R, Du X, Morgan R, Lairson D . Patterns of Treatment Sequences in Chemotherapy and Targeted Biologics for Metastatic Colorectal Cancer: Findings from a Large Community-Based Cohort of Elderly Patients. Drugs Real World Outcomes. 2016; 3(1):69-82. PMC: 4819481. DOI: 10.1007/s40801-015-0059-9. View

Parisi A, Cortellini A, Cannita K, Venditti O, Camarda F, Calegari M . Evaluation of Second-line Anti-VEGF after First-line Anti-EGFR Based Therapy in RAS Wild-Type Metastatic Colorectal Cancer: The Multicenter "SLAVE" Study. Cancers (Basel). 2020; 12(5). PMC: 7281759. DOI: 10.3390/cancers12051259. View

Abrams T, Meyer G, Schrag D, Meyerhardt J, Moloney J, Fuchs C . Chemotherapy usage patterns in a US-wide cohort of patients with metastatic colorectal cancer. J Natl Cancer Inst. 2014; 106(2):djt371. DOI: 10.1093/jnci/djt371. View

Andre T, Shiu K, Kim T, Jensen B, Jensen L, Punt C . Pembrolizumab in Microsatellite-Instability-High Advanced Colorectal Cancer. N Engl J Med. 2020; 383(23):2207-2218. DOI: 10.1056/NEJMoa2017699. View

Segelov E, Chan D, Shapiro J, Price T, Karapetis C, Tebbutt N . The role of biological therapy in metastatic colorectal cancer after first-line treatment: a meta-analysis of randomised trials. Br J Cancer. 2014; 111(6):1122-31. PMC: 4453848. DOI: 10.1038/bjc.2014.404. View

Aggarwal H, Sheffield K, Li L, Lenis D, Sorg R, Barzi A . Primary tumor location and survival in colorectal cancer: A retrospective cohort study. World J Gastrointest Oncol. 2020; 12(4):405-423. PMC: 7191328. DOI: 10.4251/wjgo.v12.i4.405. View

Tabernero J, Yoshino T, Lee Cohn A, Obermannova R, Bodoky G, Garcia-Carbonero R . Ramucirumab versus placebo in combination with second-line FOLFIRI in patients with metastatic colorectal carcinoma that progressed during or after first-line therapy with bevacizumab, oxaliplatin, and a fluoropyrimidine (RAISE): a randomised,.... Lancet Oncol. 2015; 16(5):499-508. DOI: 10.1016/S1470-2045(15)70127-0. View

Benson A, Venook A, Al-Hawary M, Arain M, Chen Y, Ciombor K . Colon Cancer, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2021; 19(3):329-359. DOI: 10.6004/jnccn.2021.0012. View

Pinto C, Di Fabio F, Rosati G, Lolli I, Ruggeri E, Ciuffreda L . Observational study on quality of life, safety, and effectiveness of first-line cetuximab plus chemotherapy in KRAS wild-type metastatic colorectal cancer patients: the ObservEr Study. Cancer Med. 2016; 5(11):3272-3281. PMC: 5119983. DOI: 10.1002/cam4.888. View

10.

Aranda E, Polo E, Camps C, Carrato A, Diaz-Rubio E, Guillem V . Treatment patterns for metastatic colorectal cancer in Spain. Clin Transl Oncol. 2020; 22(9):1455-1462. PMC: 7381444. DOI: 10.1007/s12094-019-02279-5. View

11.

Cervantes A, Adam R, Rosello S, Arnold D, Normanno N, Taieb J . Metastatic colorectal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2022; 34(1):10-32. DOI: 10.1016/j.annonc.2022.10.003. View

12.

Saltz L, Cox J, Blanke C, Rosen L, Fehrenbacher L, Moore M . Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med. 2000; 343(13):905-14. DOI: 10.1056/NEJM200009283431302. View

13.

Oweira H, Mehrabi A, Reissfelder C, Abdel-Rahman O . A Real-World, Population-Based Analysis of the Outcomes of Colorectal Cancer Patients with Isolated Synchronous Liver or Lung Metastases Treated with Metastasectomy. World J Surg. 2020; 44(5):1604-1611. DOI: 10.1007/s00268-019-05353-9. View

14.

Buchler T, Chloupkova R, Poprach A, Fiala O, Kiss I, Kopeckova K . Sequential therapy with bevacizumab and EGFR inhibitors for metastatic colorectal carcinoma: a national registry-based analysis. Cancer Manag Res. 2019; 11:359-368. PMC: 6314050. DOI: 10.2147/CMAR.S183093. View

15.

Van Cutsem E, Cervantes A, Adam R, Sobrero A, van Krieken J, Aderka D . ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol. 2016; 27(8):1386-422. DOI: 10.1093/annonc/mdw235. View

16.

Kafatos G, Banks V, Burdon P, Neasham D, Lowe K, Anger C . Impact of biomarkers and primary tumor location on the metastatic colorectal cancer first-line treatment landscape in five European countries. Future Oncol. 2021; 17(12):1495-1505. DOI: 10.2217/fon-2020-0976. View

17.

Franchi M, Garau D, Kirchmayer U, Di Martino M, Romero M, De Carlo I . Effectiveness and Costs Associated to Adding Cetuximab or Bevacizumab to Chemotherapy as Initial Treatment in Metastatic Colorectal Cancer: Results from the Observational FABIO Project. Cancers (Basel). 2020; 12(4). PMC: 7226266. DOI: 10.3390/cancers12040839. View

18.

Mayer R, Van Cutsem E, Falcone A, Yoshino T, Garcia-Carbonero R, Mizunuma N . Randomized trial of TAS-102 for refractory metastatic colorectal cancer. N Engl J Med. 2015; 372(20):1909-19. DOI: 10.1056/NEJMoa1414325. View

19.

Venook A, Niedzwiecki D, Lenz H, Innocenti F, Fruth B, Meyerhardt J . Effect of First-Line Chemotherapy Combined With Cetuximab or Bevacizumab on Overall Survival in Patients With KRAS Wild-Type Advanced or Metastatic Colorectal Cancer: A Randomized Clinical Trial. JAMA. 2017; 317(23):2392-2401. PMC: 5545896. DOI: 10.1001/jama.2017.7105. View

20.

de Gramont A, Figer A, Seymour M, Homerin M, Hmissi A, Cassidy J . Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol. 2000; 18(16):2938-47. DOI: 10.1200/JCO.2000.18.16.2938. View