Prognostic value of liver metastases in colorectal cancer treated by systemic therapy: An ARCAD pooled analysis

Cohen, Romain, Raeisi, Morteza, Chibaudel, Benoist, Shi, Qian, Yoshino, Takayuki, Zalcberg, John R., Adams, Richard ORCID: https://orcid.org/0000-0003-3915-7243, Cremolini, Chiara, Van Cutsem, Eric, Heinemann, Volker, Tabernero, Josep, Punt, Cornelis J.A., Arnold, Dirk, Hurwitz, Herbert I., Douillard, Jean-Yves, Venook, Alan P., Saltz, Leonard B., Maughan, Timothy S., Kabbinavar, Fairooz, Bokemeyer, Carsten, Grothey, Axel, Mayer, Robert J., Kaplan, Richard, Tebbutt, Niall C, Randolph Hecht, J., Giantonio, Bruce J., Díaz-Rubio, Eduardo, Sobrero, Alberto F, Peeters, Marc, Koopman, Miriam, Goldberg, Richard M., Andre, Thierry and de Gramont, Aimery 2024. Prognostic value of liver metastases in colorectal cancer treated by systemic therapy: An ARCAD pooled analysis. European Journal of Cancer 207 , 114160. 10.1016/j.ejca.2024.114160 Item availability restricted.

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Abstract

Background The liver is the most frequent site of metastases in colorectal cancer (CRC). This study aimed to assess the response rate and survival outcomes in metastatic CRC patients with non-liver metastases (NLM) compared to those with liver metastases (LM) across different lines of treatment. Methods A total of 17,924 mCRC patients included in 26 trials from the ARCAD CRC database were analyzed. The analysis was conducted based on the presence or absence of LM across different treatment groups: chemotherapy (CT) alone, CT + anti-VEGF, CT + anti-EGFR in KRAS wild-type tumors, within the first-line (1L) and second-line (2L), and patients enrolled in third-line (≥3L) trials treated with trifluridine/tipiracil or regorafenib or placebo. The endpoints were overall survival (OS), progression-free survival (PFS), and overall response rate (ORR). Results Out of the 17,924 patients, 14,066 had LM (30.6% with only liver involvement and 69.4% with liver and other metastatic sites), while 3,858 patients had NLM. In the CT alone and CT + anti-VEGF subgroups, NLM patients showed better OS and PFS in the 1L and 2L settings. However, in the CT + anti-EGFR 1L and 2L subgroups, there was no significant difference in OS and PFS between NLM and LM patients. In the ≥3L subgroups, better OS and PFS were observed in NLM patients. ORRs were higher in LM patients than in NLM patients across all cohorts treated in the 1L and only in the anti-EGFR cohort in the 2L. Conclusion LM is a poor prognostic factor for mCRC increasing from 1L to ≥3L except for patients in 1L and 2L receiving CT+anti-EGFR. These data justify using LM as a stratification factor in future trials for patients with unresectable mCRC.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine Centre for Trials Research (CNTRR)
Additional Information:	License information from Publisher: LICENSE 1: Title: This article is under embargo with an end date yet to be finalised.
Publisher:	Elsevier
ISSN:	0959-8049
Date of First Compliant Deposit:	14 June 2024
Date of Acceptance:	30 May 2024
Last Modified:	09 Nov 2024 15:45
URI:	https://orca.cardiff.ac.uk/id/eprint/169805

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