TY - JOUR
T1 - Transverse Colon Primary Tumor Location as a Biomarker in Metastatic Colorectal Cancer
T2 - A Pooled Analysis of CCTG/AGITG CO.17 and CO.20 Randomized Clinical Trials
AU - Vasconcelos, Joao Paulo Solar
AU - Chen, Nan
AU - Titmuss, Emma
AU - Tu, Dongsheng
AU - Brule, Stephanie Y.
AU - Goodwin, Rachel
AU - Jonker, Derek J.
AU - Price, Timothy
AU - Zalcberg, John R.
AU - Moore, Malcolm J.
AU - Karapetis, Christos S.
AU - Siu, Lillian
AU - Shapiro, Jeremy
AU - Simes, John
AU - Gill, Sharlene
AU - O’Callaghan, Chris J.
AU - Loree, Jonathan M.
PY - 2024/3/15
Y1 - 2024/3/15
N2 - Purpose: Sidedness is prognostic and predictive of anti-EGFR efficacy in metastatic colorectal cancer (mCRC). Transverse colon has been historically excluded from several analyses of sidedness and the optimal division between left- and right-sided colorectal cancer is unclear. We investigated transverse colon primary tumor location as a biomarker in mCRC. Experimental Design: Pooled analysis of CCTG/AGITG CO.17 and CO.20 trials of cetuximab in chemotherapy-refractory mCRC. Outcomes of patients with RAS/BRAF wild-type (WT) mCRC from CO.17 and KRAS WT mCRC from CO.20 were analyzed according to location. Results: A total of 553 patients were analyzed, 32 (5.8%) with cancers from the transverse, 101 (18.3%) from right, and 420 from (75.9%) left colon. Transverse mCRC failed to reach significant benefit from cetuximab versus best supportive care (BSC) for overall survival [OS; median, 5.9 vs. 2.1 months; HR, 0.63; 95% confidence interval (CI), 0.28–1.42; P¼0.26] and progression-free survival (PFS; median, 1.8 vs. 1.3 months; HR, 0.57; 95% CI, 0.26–1.28; P¼0.16). Analyzing exclusively patients randomized to cetuximab, right-sided and transverse had comparable outcomes for OS (median, 5.6 vs. 5.9 months; HR, 0.82; 95% CI, 0.50–1.34; P¼0.43) and PFS (median, 1.9 vs. 1.8 months; HR, 0.78; 95% CI, 0.49–1.26; P¼0.31). Patients with left-sided mCRC had superior outcomes with cetuximab compared with transverse for OS (median, 9.7 vs. 5.9 months; HR, 0.42; 95% CI, 0.27–0.67; P¼0.0002) and PFS (median, 3.8 vs. 1.8 months; HR, 0,49; 95% CI, 0.31–0.76; P¼0.001). Location was not prognostic in patients treated with BSC alone. Conclusions: Transverse mCRC has comparable prognostic and predictive features with right-sided mCRC.
AB - Purpose: Sidedness is prognostic and predictive of anti-EGFR efficacy in metastatic colorectal cancer (mCRC). Transverse colon has been historically excluded from several analyses of sidedness and the optimal division between left- and right-sided colorectal cancer is unclear. We investigated transverse colon primary tumor location as a biomarker in mCRC. Experimental Design: Pooled analysis of CCTG/AGITG CO.17 and CO.20 trials of cetuximab in chemotherapy-refractory mCRC. Outcomes of patients with RAS/BRAF wild-type (WT) mCRC from CO.17 and KRAS WT mCRC from CO.20 were analyzed according to location. Results: A total of 553 patients were analyzed, 32 (5.8%) with cancers from the transverse, 101 (18.3%) from right, and 420 from (75.9%) left colon. Transverse mCRC failed to reach significant benefit from cetuximab versus best supportive care (BSC) for overall survival [OS; median, 5.9 vs. 2.1 months; HR, 0.63; 95% confidence interval (CI), 0.28–1.42; P¼0.26] and progression-free survival (PFS; median, 1.8 vs. 1.3 months; HR, 0.57; 95% CI, 0.26–1.28; P¼0.16). Analyzing exclusively patients randomized to cetuximab, right-sided and transverse had comparable outcomes for OS (median, 5.6 vs. 5.9 months; HR, 0.82; 95% CI, 0.50–1.34; P¼0.43) and PFS (median, 1.9 vs. 1.8 months; HR, 0.78; 95% CI, 0.49–1.26; P¼0.31). Patients with left-sided mCRC had superior outcomes with cetuximab compared with transverse for OS (median, 9.7 vs. 5.9 months; HR, 0.42; 95% CI, 0.27–0.67; P¼0.0002) and PFS (median, 3.8 vs. 1.8 months; HR, 0,49; 95% CI, 0.31–0.76; P¼0.001). Location was not prognostic in patients treated with BSC alone. Conclusions: Transverse mCRC has comparable prognostic and predictive features with right-sided mCRC.
KW - transverse colon
KW - primary tumor
KW - metastatic colorectal cancer
KW - CCTG/AGITG CO.17
KW - randomized clinical trials
UR - http://www.scopus.com/inward/record.url?scp=85187948044&partnerID=8YFLogxK
U2 - 10.1158/1078-0432.CCR-23-3275
DO - 10.1158/1078-0432.CCR-23-3275
M3 - Article
C2 - 38170586
AN - SCOPUS:85187948044
SN - 1078-0432
VL - 30
SP - 1121
EP - 1130
JO - Clinical Cancer Research
JF - Clinical Cancer Research
IS - 6
ER -