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Treatment Patterns and Prognosis of Palliative Chemotherapy Combined With Targeting Agents in Patients With Unresectable Metastatic Colorectal Cancer: CHOICE, A Multicenter Longitudinal Observational Study

Authors
Kim, Jwa HoonCha, YongjunShin, Sang JoonPark, Young SukKang, Jung HunKim, ChanLim, Sung HeeKang, Myoung JooKim, Jong GwangHwang, In GyuChoi, Jong-KwonShin, Seong HoonKang, Seok YunLee, Sang-CheolLim, Seung TaekKim, Jung SunJeung, Hei-CheulKang, Myoung HeeChoi, In SilRyu, Hye WonLee, Kyung HeeLee, Moon HeeLee, Ji YoungPark, Ji HyunJeon, So-YeonLee, NamsuPark, Chi-YoungKim, Yeul Hong
Issue Date
Jan-2024
Publisher
INT INST ANTICANCER RESEARCH
Keywords
Colorectal cancer; efficacy; mutation status; primary tumor location; treatment patterns
Citation
Anticancer research, v.44, no.1, pp 347 - 359
Pages
13
Indexed
SCOPUS
Journal Title
Anticancer research
Volume
44
Number
1
Start Page
347
End Page
359
URI
https://scholarworks.gnu.ac.kr/handle/sw.gnu/69360
DOI
10.21873/anticanres.16818
ISSN
0250-7005
1791-7530
Abstract
BACKGROUND/AIM: This study investigated the treatment patterns and prognosis of patients with metastatic or unresectable colorectal cancer (mCRC) treated with chemotherapy with targeting agents. PATIENTS AND METHODS: This longitudinal multicenter study included 963 patients with mCRC who were treated in Korea between 2016 and 2020. Treatment patterns and efficacy were compared according to the mutation status and clinical factors. RESULTS: As first-line therapy, most of the patients (83.5%) received FOLFOX plus bevacizumab (35.4%), followed by FOLFIRI plus bevacizumab (18.8%), FOLFIRI plus cetuximab (17.0%), and FOLFOX plus cetuximab (12.3%). Bevacizumab was the most frequent agent (78.8%) combined with chemotherapy in RAS-mutated CRC, while cetuximab (57.2%) in RAS wild-type CRC. Cetuximab was frequently combined with a doublet regimen in patients with left-sided CRC than in those with right-sided CRC (34.4% vs. 16%). As second-line therapy, most patients (63.4%) also received doublet regimens with bevacizumab, and FOLFIRI plus aflibercept was administered in 15.1%. The objective response rate with FOLFIRI plus cetuximab was significantly higher in patients with left-sided CRC than in those with right-sided CRC (59.2% vs. 30.8%, p=0.008) and marginally higher in patients with RAS wild-type CRC than in those with RAS-mutated CRC (55.6% vs. 0.0%, p=0.092). Progression-free survival (PFS) with FOLFOX plus bevacizumab was significantly shorter than that with FOLFIRI plus bevacizumab (p=0.030) in RAS-mutated CRC, whereas there were no significant differences between regimens in RAS wild-type CRC. CONCLUSION: In patients with unresectable metastatic colorectal cancer, doublet chemotherapy with targeting agents is the most common therapy and efficacy depends on the mutation status as well as clinical factors. Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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