Anti‐epidermal or anti‐vascular endothelial growth factor as first‐line metastatic colorectal cancer in modified Glasgow prognostic score 2' patients

Journal of Cachexia, Sarcopenia and Muscle

Johann Dréanic²  Marion Dhooge²  Maximilien Barret²  Catherine Brezault²  Olivier Mir¹  Stanislas Chaussade² 

[1] Medical Oncology, Department of Cancer Medicine, Gustave Roussy, Cancer Campus Grand Paris, Villejuif, France;Gastroenterology and Endoscopy Unit, Hôpital Cochin, Université Paris Descartes, Sorbonne Paris Cité, Faculté de médecine, AP-HP, Paris, France

关键词: Colorectal cancer;    C‐reactive protein;    Glasgow prognostic score;    Targeted therapy;    Bevacizumab;    Cetuximab;    Vascular epithelial growth factor;    Epidermal growth factor receptor;   

DOI  :  10.1002/jcsm.12022

来源: Wiley

【 摘 要 】

Abstract

Background

In metastatic colorectal cancer, the modified Glasgow prognostic score (mGPS) has been approved as an independent prognostic indicator of survival. No data existed on poor prognosis patients treated with molecular-targeted agents.

Methods

From January 2007 to February 2012, patients with metastatic colorectal cancer and poor predictive survival score (mGPS = 2), treated with 5-fluorouracil-based chemotherapy in addition to an anti-epidermal growth factor receptor (EGFR) or anti-vascular epidermal growth factor (VEGF) therapy, were included to assess the interest of targeted therapy within mGPS = 2' patients.

Results

A total of 27 mGPS = 2' patients were included and received a 5-fluorouracil-based systemic chemotherapy in addition to an anti-EGFR treatment (cetuximab; n = 18) or an anti-VEGF treatment (bevacizumab; n = 9). Median follow-up was 12.1 months (interquartile range 4.9–22). Patients were Eastern Cooperative Oncology Group (ECOG) Performance Status 1, 2, and 3 in 66% (n = 18), 26% (n = 7), and 8% (n = 2), respectively. Comparing anti-EGFR and anti-VEGF groups, median progression-free survival was 3.9 and 15.4 months, respectively, and was significantly different (P = 0.046). Conversely, the median overall survival was not significantly different between the two groups (P = 0.15).

Conclusion

Our study confirmed the poor survival of patients with mGPS = 2 despite the use of targeted therapy and identified the superiority of an anti-VEGF treatment in progression-free survival, without a significant benefit in the overall survival compared with the anti-EGFR therapy. Our results deserved confirmation by a prospective clinical trial.

【 授权许可】

CC BY-NC-ND   
© 2015 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society of Sarcopenia, Cachexia and Wasting Disorders

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