Hui-Li Wong1, Belinda Lee2, Kathryn Field3, Anna Lomax4, Mark Tacey5, Jeremy Shapiro6, Joe McKendrick4, Allan Zimet7, Desmond Yip8, Louise Nott9, Ross Jennens7, Gary Richardson10, Jeanne Tie11, Suzanne Kosmider12, Phillip Parente4, Lionel Lim13, Prasad Cooray4, Ben Tran1, Jayesh Desai3, Rachel Wong14, Peter Gibbs15. 1. Systems Biology and Personalised Medicine Division, Walter & Eliza Hall Institute of Medical Research (WEHI), Parkville, Melbourne, Australia; Department of Medical Oncology, The Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia. 2. Systems Biology and Personalised Medicine Division, Walter & Eliza Hall Institute of Medical Research (WEHI), Parkville, Melbourne, Australia; Department of Medical Oncology, The Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia. Electronic address: Belinda.lee@mh.org.au. 3. Department of Medical Oncology, The Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia. 4. Eastern Health, Department of Medical Oncology, Melbourne, Victoria, Australia. 5. Department of Medical Oncology, The Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia; Department of Health Education and Research, Melbourne EpiCentre, The Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia. 6. Cabrini Health, Department of Oncology, Malvern, Melbourne, Victoria, Australia; Department of Medicine, Nursing & Health Sciences, Monash University, Parkville, Melbourne, Victoria, Australia. 7. Department of Oncology, Epworth Hospital, Richmond, Victoria, Australia. 8. Department of Medical Oncology, Canberra and Calvary Hospitals, Garran, Australian Capital Territory, Australia. 9. Department of Medical Oncology, Royal Hobart Hospital, Hobart, Tasmania, Australia. 10. Cabrini Health, Department of Oncology, Malvern, Melbourne, Victoria, Australia. 11. Systems Biology and Personalised Medicine Division, Walter & Eliza Hall Institute of Medical Research (WEHI), Parkville, Melbourne, Australia; Department of Medical Oncology, The Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia; Western Health, Department of Medical Oncology, Footscray, Melbourne, Victoria, Australia. 12. Western Health, Department of Medical Oncology, Footscray, Melbourne, Victoria, Australia. 13. Eastern Health, Department of Medical Oncology, Melbourne, Victoria, Australia; Department of Oncology, Ringwood Private Hospital, Ringwood East, Victoria, Australia. 14. Systems Biology and Personalised Medicine Division, Walter & Eliza Hall Institute of Medical Research (WEHI), Parkville, Melbourne, Australia; Eastern Health, Department of Medical Oncology, Melbourne, Victoria, Australia; Department of Medicine, Nursing & Health Sciences, Monash University, Parkville, Melbourne, Victoria, Australia. 15. Systems Biology and Personalised Medicine Division, Walter & Eliza Hall Institute of Medical Research (WEHI), Parkville, Melbourne, Australia; Department of Medical Oncology, The Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia; Western Health, Department of Medical Oncology, Footscray, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: With an ever-increasing focus on personalized medicine, all factors known to affect treatment response need to be considered when defining optimal therapy for individual patients. While the prognostic impact of primary tumor site on colorectal cancer (CRC) outcomes is established, emerging data suggest potential differences in response to biologic therapies. We studied the impact of tumor site on bevacizumab efficacy in patients with metastatic CRC. PATIENTS AND METHODS: We analyzed data of patients in an Australian prospective multicenter metastatic CRC (mCRC) registry who received first-line chemotherapy. Tumor site was defined as right colon, cecum to transverse; left colon, splenic flexure to rectosigmoid; and rectum. Kaplan-Meier and Cox models were used for survival analyses. RESULTS: Of 926 patients, 297 had right colon, 354 left colon, and 275 rectum primary disease. Median age was 68.6, 65.9, and 63.3 years, respectively (P = .001). Right colon disease was significantly associated with intraperitoneal spread (P < .0001), while left colon and rectum disease preferentially metastasized to the liver and lungs, respectively (P < .0001 in both settings). A total of 636 patients (68.7%) received bevacizumab. Progression-free survival was superior for bevacizumab-treated patients in all groups but appeared greatest in right colon disease (hazard ratio, 0.46; 95% confidence interval, 0.36-0.60; P ≤ .001). Overall survival was longest in patients with disease of the rectum, followed by left colon and right colon (median, 26.2, 23.6, and 18.2 months, respectively; P = .0004). CONCLUSION: Tumor site appears to be prognostic in mCRC, with rectum and right colon disease associated with the best and worst outcomes, respectively. Patients who received bevacizumab in addition to chemotherapy had superior outcomes, with the effect appearing greatest in patients with right colon disease.
BACKGROUND: With an ever-increasing focus on personalized medicine, all factors known to affect treatment response need to be considered when defining optimal therapy for individual patients. While the prognostic impact of primary tumor site on colorectal cancer (CRC) outcomes is established, emerging data suggest potential differences in response to biologic therapies. We studied the impact of tumor site on bevacizumab efficacy in patients with metastatic CRC. PATIENTS AND METHODS: We analyzed data of patients in an Australian prospective multicenter metastatic CRC (mCRC) registry who received first-line chemotherapy. Tumor site was defined as right colon, cecum to transverse; left colon, splenic flexure to rectosigmoid; and rectum. Kaplan-Meier and Cox models were used for survival analyses. RESULTS: Of 926 patients, 297 had right colon, 354 left colon, and 275 rectum primary disease. Median age was 68.6, 65.9, and 63.3 years, respectively (P = .001). Right colon disease was significantly associated with intraperitoneal spread (P < .0001), while left colon and rectum disease preferentially metastasized to the liver and lungs, respectively (P < .0001 in both settings). A total of 636 patients (68.7%) received bevacizumab. Progression-free survival was superior for bevacizumab-treated patients in all groups but appeared greatest in right colon disease (hazard ratio, 0.46; 95% confidence interval, 0.36-0.60; P ≤ .001). Overall survival was longest in patients with disease of the rectum, followed by left colon and right colon (median, 26.2, 23.6, and 18.2 months, respectively; P = .0004). CONCLUSION:Tumor site appears to be prognostic in mCRC, with rectum and right colon disease associated with the best and worst outcomes, respectively. Patients who received bevacizumab in addition to chemotherapy had superior outcomes, with the effect appearing greatest in patients with right colon disease.
Authors: Mayada A Aljehani; John W Morgan; Laurel A Guthrie; Brice Jabo; Majed Ramadan; Khaled Bahjri; Sharon S Lum; Matthew Selleck; Mark E Reeves; Carlos Garberoglio; Maheswari Senthil Journal: JAMA Surg Date: 2018-01-01 Impact factor: 14.766
Authors: D Arnold; B Lueza; J-Y Douillard; M Peeters; H-J Lenz; A Venook; V Heinemann; E Van Cutsem; J-P Pignon; J Tabernero; A Cervantes; F Ciardiello Journal: Ann Oncol Date: 2017-08-01 Impact factor: 32.976
Authors: Mohammad Adileh; Jonathan B Yuval; Henry S Walch; Walid K Chatila; Rona Yaeger; Julio Garcia-Aguilar; Nikolaus Schultz; Philip B Paty; Andrea Cercek; Garrett M Nash Journal: Ann Surg Oncol Date: 2020-08-25 Impact factor: 5.344
Authors: Jiao Yang; Xiang Lin Du; Shu Ting Li; Bi Yuan Wang; Yin Ying Wu; Zhe Ling Chen; Meng Lv; Yan Wei Shen; Xin Wang; Dan Feng Dong; Dan Li; Fan Wang; En Xiao Li; Min Yi; Jin Yang Journal: PLoS One Date: 2016-12-09 Impact factor: 3.240