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Impact of early tumor shrinkage on clinical outcome in wild‐type‐ KRAS colorectal liver metastases treated with cetuximab
Author(s) -
Ye Lechi,
Wei Ye,
Zhu Dexiang,
Chen Tao,
Xu Jianmin
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12847
Subject(s) - medicine , cetuximab , kras , chemotherapy , colorectal cancer , gastroenterology , oncology , surgery , cancer
Background and Aim To evaluate the impact of early tumor shrinkage ( ETS ) on long‐term outcome in patients with wild‐type Kirsten rat sarcoma viral oncogene homolog (KRAS) unresectable colorectal liver metastases ( CLM ) receiving cetuximab plus chemotherapy. Methods A total of 138 patients in a randomized controlled trial (70 in arm A received cetuximab plus chemotherapy, 68 in arm B received chemotherapy alone), as previously reported ( Y e et al ., 2013) were included into this analysis. The cut‐off date updated for overall survival ( OS ) was J une 2014. ETS was defined as a ≥ 20% reduction of the longest diameters of the target lesions compared with baseline at the first evaluation (8 weeks). Outcome measures were progression‐free survival ( PFS ) and OS . Results There were 132 patients available for evaluation, and ETS occurred more frequently in arm A than that in arm B ( P = 0.003). ETS was associated with longer OS (arm A : 35.7 vs 19.5 months, P < 0.001; arm B 28.7 vs 18.7 months, P = 0.01) and PFS (arm A : 13.4 vs 4.2 months, P < 0.001; arm B 7.0 vs 4.2 months, P = 0.001) compared with patients with no‐ ETS . Among patients with ETS , there was a significant difference between arm A and arm B in PFS ( P = 0.03), but not in OS ( P = 0.19). All 23 patients who underwent liver surgery achieved ETS . In arm A , for patients without liver surgery, patients observed ETS also gained an increased survival benefit over those no‐ ETS in OS ( P = 0.02) and PFS ( P < 0.001). ETS was an independent predictor of improved OS (hazard ratio 0.56, P = 0.007). Conclusion ETS may serve as a predictor of favorable outcome in patients with wild‐type KRAS CLM receiving cetuximab plus chemotherapy.