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Primary Tumor Sidedness Predicts Bevacizumab Benefit in Metastatic Colorectal Cancer Patients

The emerging debate between primary tumor location and clinical outcome of bevacizumab treated metastatic colorectal cancer (mCRC) continues. The aim of the present study is to investigate the association between the primary tumor location and clinical outcome of 115 mCRC patients receiving bevacizu...

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Autores principales: You, Xia-Hong, Wen, Can, Xia, Zi-Jin, Sun, Fan, Li, Yao, Wang, Wei, Fang, Zhou, Chen, Qing-Gen, Zhang, Lei, Jiang, Yu-Huang, Wang, Xiao-Zhong, Ying, Hou-Qun, Zong, Zhen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702298/
https://www.ncbi.nlm.nih.gov/pubmed/31475100
http://dx.doi.org/10.3389/fonc.2019.00723
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author You, Xia-Hong
Wen, Can
Xia, Zi-Jin
Sun, Fan
Li, Yao
Wang, Wei
Fang, Zhou
Chen, Qing-Gen
Zhang, Lei
Jiang, Yu-Huang
Wang, Xiao-Zhong
Ying, Hou-Qun
Zong, Zhen
author_facet You, Xia-Hong
Wen, Can
Xia, Zi-Jin
Sun, Fan
Li, Yao
Wang, Wei
Fang, Zhou
Chen, Qing-Gen
Zhang, Lei
Jiang, Yu-Huang
Wang, Xiao-Zhong
Ying, Hou-Qun
Zong, Zhen
author_sort You, Xia-Hong
collection PubMed
description The emerging debate between primary tumor location and clinical outcome of bevacizumab treated metastatic colorectal cancer (mCRC) continues. The aim of the present study is to investigate the association between the primary tumor location and clinical outcome of 115 mCRC patients receiving bevacizumab based treatment. A meta-analysis including 21 studies was carried out to confirm the conclusion. In our prospective study, we found that right-sided mCRC commonly occurred in older cases (p = 0.03) with multiple-site metastasis (p = 0.03). Progression-free survival (PFS) of the left-sided patients undergoing bevacizumab plus a FOLFIRI regimen was superior to the right-sided cases (p = 0.03, crude HR = 0.31, 95%CI = 0.11–0.87; adjusted HR = 0.21, 95%CI = 0.06–0.66). The meta-analysis confirmed that efficacy of bevacizumab-based treatment in left-sided mCRC patients was better than the right-sided cases in the overall population (P(h) = 0.24, combined OR = 1.36, 95%CI = 1.07–1.72), RAS/BRAF wild-type (P(h) = 0.19, combined OR = 1.66, 95%CI = 1.17–2.34), clinical trial (P(h) = 0.23, combined OR = 1.42, 95%CI = 1.07–1.88), Caucasian population (P(h) = 0.18, combined OR = 1.37, 95%CI = 1.02–1.85) and first-line (P(h) = 0.19, combined OR = 1.48, 95%CI = 1.13–1.96) subgroups. Improved survival of bevacizumab plus chemotherapy treated left-sided mCRC patients was observed in the overall population [P(h) < 0.01, combined MSR = 1.09, 95%CI = 1.00–1.18 for PFS; P(h) < 0.01, combined MSR = 1.24, 95%CI = 1.13–1.36 for overall survival (OS)], especially in the RAS/BRAF wild-type (P(h) = 0.09, combined MSR = 1.10, 95%CI = 1.03–1.19 for PFS; P(h) = 0.02, combined MSR = 1.34, 95%CI = 1.21–1.49 for OS). These findings indicate that primary tumor sidedness can predict clinical outcome of bevacizumab-treated RAS/BRAF wild-type mCRC patients and the left-sided patients may benefit more from bevacizumab plus FOLFIRI.
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spelling pubmed-67022982019-08-30 Primary Tumor Sidedness Predicts Bevacizumab Benefit in Metastatic Colorectal Cancer Patients You, Xia-Hong Wen, Can Xia, Zi-Jin Sun, Fan Li, Yao Wang, Wei Fang, Zhou Chen, Qing-Gen Zhang, Lei Jiang, Yu-Huang Wang, Xiao-Zhong Ying, Hou-Qun Zong, Zhen Front Oncol Oncology The emerging debate between primary tumor location and clinical outcome of bevacizumab treated metastatic colorectal cancer (mCRC) continues. The aim of the present study is to investigate the association between the primary tumor location and clinical outcome of 115 mCRC patients receiving bevacizumab based treatment. A meta-analysis including 21 studies was carried out to confirm the conclusion. In our prospective study, we found that right-sided mCRC commonly occurred in older cases (p = 0.03) with multiple-site metastasis (p = 0.03). Progression-free survival (PFS) of the left-sided patients undergoing bevacizumab plus a FOLFIRI regimen was superior to the right-sided cases (p = 0.03, crude HR = 0.31, 95%CI = 0.11–0.87; adjusted HR = 0.21, 95%CI = 0.06–0.66). The meta-analysis confirmed that efficacy of bevacizumab-based treatment in left-sided mCRC patients was better than the right-sided cases in the overall population (P(h) = 0.24, combined OR = 1.36, 95%CI = 1.07–1.72), RAS/BRAF wild-type (P(h) = 0.19, combined OR = 1.66, 95%CI = 1.17–2.34), clinical trial (P(h) = 0.23, combined OR = 1.42, 95%CI = 1.07–1.88), Caucasian population (P(h) = 0.18, combined OR = 1.37, 95%CI = 1.02–1.85) and first-line (P(h) = 0.19, combined OR = 1.48, 95%CI = 1.13–1.96) subgroups. Improved survival of bevacizumab plus chemotherapy treated left-sided mCRC patients was observed in the overall population [P(h) < 0.01, combined MSR = 1.09, 95%CI = 1.00–1.18 for PFS; P(h) < 0.01, combined MSR = 1.24, 95%CI = 1.13–1.36 for overall survival (OS)], especially in the RAS/BRAF wild-type (P(h) = 0.09, combined MSR = 1.10, 95%CI = 1.03–1.19 for PFS; P(h) = 0.02, combined MSR = 1.34, 95%CI = 1.21–1.49 for OS). These findings indicate that primary tumor sidedness can predict clinical outcome of bevacizumab-treated RAS/BRAF wild-type mCRC patients and the left-sided patients may benefit more from bevacizumab plus FOLFIRI. Frontiers Media S.A. 2019-08-14 /pmc/articles/PMC6702298/ /pubmed/31475100 http://dx.doi.org/10.3389/fonc.2019.00723 Text en Copyright © 2019 You, Wen, Xia, Sun, Li, Wang, Fang, Chen, Zhang, Jiang, Wang, Ying and Zong. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
You, Xia-Hong
Wen, Can
Xia, Zi-Jin
Sun, Fan
Li, Yao
Wang, Wei
Fang, Zhou
Chen, Qing-Gen
Zhang, Lei
Jiang, Yu-Huang
Wang, Xiao-Zhong
Ying, Hou-Qun
Zong, Zhen
Primary Tumor Sidedness Predicts Bevacizumab Benefit in Metastatic Colorectal Cancer Patients
title Primary Tumor Sidedness Predicts Bevacizumab Benefit in Metastatic Colorectal Cancer Patients
title_full Primary Tumor Sidedness Predicts Bevacizumab Benefit in Metastatic Colorectal Cancer Patients
title_fullStr Primary Tumor Sidedness Predicts Bevacizumab Benefit in Metastatic Colorectal Cancer Patients
title_full_unstemmed Primary Tumor Sidedness Predicts Bevacizumab Benefit in Metastatic Colorectal Cancer Patients
title_short Primary Tumor Sidedness Predicts Bevacizumab Benefit in Metastatic Colorectal Cancer Patients
title_sort primary tumor sidedness predicts bevacizumab benefit in metastatic colorectal cancer patients
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702298/
https://www.ncbi.nlm.nih.gov/pubmed/31475100
http://dx.doi.org/10.3389/fonc.2019.00723
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