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01.02.2016 | Original Research

Secondary Metastases Resection After Bevacizumab Plus Irinotecan-Based Chemotherapy in First-Line Therapy of Metastatic Colorectal Cancer in a Real-Life Setting: Results of the ETNA Cohort

verfasst von: Magali Rouyer, Denis Smith, Christophe Laurent, Yves Becouarn, Rosine Guimbaud, Pierre Michel, Nicole Tubiana-Mathieu, Aurélie Balestra, Jérémy Jové, Philip Robinson, Pernelle Noize, Nicholas Moore, Alain Ravaud, Annie Fourrier-Réglat, on behalf of the ETNA study group

Erschienen in: Targeted Oncology | Ausgabe 1/2016

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Abstract

Purpose

Resection of metastases after chemotherapy improves survival outcomes of patients with initially inoperable metastatic colorectal cancer (mCRC), yet little data is available for those treated in the first-line setting with bevacizumab plus irinotecan. To provide data on this, the present study described the subgroup of the ETNA cohort who underwent metastases surgery.

Methods

The population of operated patients was described according to metastatic site (exclusively hepatic, non-exclusively hepatic, and non-hepatic). Factors associated with overall survival (OS) and progression-free survival (PFS) were evaluated using multivariable Cox analysis.

Results

A total of 76 patients (21.1 % of the ETNA cohort) underwent metastases resection: 50 % male, median age 61.9 years, 85.5 % ECOG ≤ 1, and median duration of bevacizumab use 7.2 months. No surgery-related deaths were observed and 30.6 % of patients had at least one post-operative complication, mainly infections (11.8 % of resections), bleeding complications (3.5 %), or delayed wound healing (2.4 %). Complete remission was higher for those with exclusively hepatic metastases (22/32, 68.8 %) than those with non-exclusively hepatic metastases (12/24, 50.0 %), or non-hepatic metastases (12/20, 60.0 %). Among operated patients, 52.6 % had died after 5 years of follow-up. In multivariable analysis at 2 years of follow-up, death (HR 0.09 [95 % CI 0.02-0.35]) and progression (HR 0.35 [95 % CI 0.23-0.56]) were less likely for patients with complete remission (CR) after surgery R0-R1 or radiofrequency ablation (RFA) [CR RFA] compared with those who were not resected or with R2 resection.

Conclusion

In real-life practice, bevacizumab with irinotecan in first-line therapy for mCRC allows secondary resection of metastases and survival is more favourable in those with complete remission (R0-R1/CR RFA).

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Titel: Secondary Metastases Resection After Bevacizumab Plus Irinotecan-Based Chemotherapy in First-Line Therapy of Metastatic Colorectal Cancer in a Real-Life Setting: Results of the ETNA Cohort
verfasst von: Magali Rouyer
Denis Smith
Christophe Laurent
Yves Becouarn
Rosine Guimbaud
Pierre Michel
Nicole Tubiana-Mathieu
Aurélie Balestra
Jérémy Jové
Philip Robinson
Pernelle Noize
Nicholas Moore
Alain Ravaud
Annie Fourrier-Réglat
on behalf of the ETNA study group
Publikationsdatum: 01.02.2016
Verlag: Springer International Publishing
Erschienen in: Targeted Oncology / Ausgabe 1/2016
Print ISSN: 1776-2596
Elektronische ISSN: 1776-260X
DOI: https://doi.org/10.1007/s11523-015-0377-6

Springer Medizin

Secondary Metastases Resection After Bevacizumab Plus Irinotecan-Based Chemotherapy in First-Line Therapy of Metastatic Colorectal Cancer in a Real-Life Setting: Results of the ETNA Cohort