Predictive factors of severe early treatment-related toxicity in patients receiving first-line treatment for metastatic colorectal cancer : Pooled analysis of 2190 patients enrolled in Fédération Francophone de Cancérologie Digestive (FFCD) trials
Copyright © 2021 Elsevier Ltd. All rights reserved..
AIM: Few studies have explored the association between baseline characteristics and the occurrence of early toxicities in patients treated with first-line chemotherapy for metastatic colorectal cancer (mCRC).
PATIENTS AND METHODS: Individual patient data of 2190 patients enrolled in 10 prospective FFCD (Fédération Francophone de Cancérologie Digestive) trials were analysed. Severe early toxicity was defined as the occurrence of grade ≥III toxicity within 3 months after initiation of chemotherapy (ET3).
RESULTS: Patients received monotherapy based on 5-FU (n = 1068), a cytotoxic doublet (n = 395) or tritherapy with a cytotoxic doublet plus anti-VEGF agent or a cytotoxic triplet (n = 727). The patients received 5-FU (100%), Irinotecan (39.6%), Oxaliplatin (13.4%), Bevacizumab (29.6%) or Aflibercept (1.8%). ET3 occurred in 244 patients (22.8%) with monotherapy, 248 patients (62.8%) with doublet and 392 patients (53.9%) with tritherapy. The most frequent ET3s were related to biological abnormalities and/or gastrointestinal, general and vascular disorders. The prognostic factors for the occurrence of an ET3 in multivariate analysis were a performance status of 2 rather than 0-1 (OR 2.57; 95% CI [1.16, 5.73]; p = 0.02), tritherapy versus monotherapy (OR 2.31; 95% CI [0.84, 6.33]; p = 0.02), alkaline phosphatase > 300 UI/l (OR 3.07; 95% CI [1.79, 5.27]; p < 0.001) and non-resected primary tumour versus resection (OR 1.59; 95% CI [1.06, 2.39]; p = 0.02). Median overall survival in patients without ET3 was significantly longer than that in patients with ET3 (HR 0.87; 95% CI [0.80-0.96]; p = 0.004).
CONCLUSION: ET3 is frequent whatever the treatment regimen and is associated with certain baseline characteristics. The clinical impact of ET3 on prognosis in mCRC warrants further investigation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:153 |
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| Enthalten in: |
European journal of cancer (Oxford, England : 1990) - 153(2021) vom: 15. Aug., Seite 40-50 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Breton, Clémence [VerfasserIn] |
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| Links: |
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| Themen: |
Baseline characteristics |
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| Anmerkungen: |
Date Completed 07.12.2021 Date Revised 14.12.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ejca.2021.04.040 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM326778950 |
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| 100 | 1 | |a Breton, Clémence |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Predictive factors of severe early treatment-related toxicity in patients receiving first-line treatment for metastatic colorectal cancer |b Pooled analysis of 2190 patients enrolled in Fédération Francophone de Cancérologie Digestive (FFCD) trials |
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| 500 | |a Date Completed 07.12.2021 | ||
| 500 | |a Date Revised 14.12.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Elsevier Ltd. All rights reserved. | ||
| 520 | |a AIM: Few studies have explored the association between baseline characteristics and the occurrence of early toxicities in patients treated with first-line chemotherapy for metastatic colorectal cancer (mCRC) | ||
| 520 | |a PATIENTS AND METHODS: Individual patient data of 2190 patients enrolled in 10 prospective FFCD (Fédération Francophone de Cancérologie Digestive) trials were analysed. Severe early toxicity was defined as the occurrence of grade ≥III toxicity within 3 months after initiation of chemotherapy (ET3) | ||
| 520 | |a RESULTS: Patients received monotherapy based on 5-FU (n = 1068), a cytotoxic doublet (n = 395) or tritherapy with a cytotoxic doublet plus anti-VEGF agent or a cytotoxic triplet (n = 727). The patients received 5-FU (100%), Irinotecan (39.6%), Oxaliplatin (13.4%), Bevacizumab (29.6%) or Aflibercept (1.8%). ET3 occurred in 244 patients (22.8%) with monotherapy, 248 patients (62.8%) with doublet and 392 patients (53.9%) with tritherapy. The most frequent ET3s were related to biological abnormalities and/or gastrointestinal, general and vascular disorders. The prognostic factors for the occurrence of an ET3 in multivariate analysis were a performance status of 2 rather than 0-1 (OR 2.57; 95% CI [1.16, 5.73]; p = 0.02), tritherapy versus monotherapy (OR 2.31; 95% CI [0.84, 6.33]; p = 0.02), alkaline phosphatase > 300 UI/l (OR 3.07; 95% CI [1.79, 5.27]; p < 0.001) and non-resected primary tumour versus resection (OR 1.59; 95% CI [1.06, 2.39]; p = 0.02). Median overall survival in patients without ET3 was significantly longer than that in patients with ET3 (HR 0.87; 95% CI [0.80-0.96]; p = 0.004) | ||
| 520 | |a CONCLUSION: ET3 is frequent whatever the treatment regimen and is associated with certain baseline characteristics. The clinical impact of ET3 on prognosis in mCRC warrants further investigation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Baseline characteristics | |
| 650 | 4 | |a Chemotherapy | |
| 650 | 4 | |a Colorectal cancer | |
| 650 | 4 | |a Prognostic factors | |
| 650 | 4 | |a Toxicities | |
| 700 | 1 | |a Aparicio, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Le Malicot, Karine |e verfasserin |4 aut | |
| 700 | 1 | |a Ducreux, Michel |e verfasserin |4 aut | |
| 700 | 1 | |a Lecomte, Thierry |e verfasserin |4 aut | |
| 700 | 1 | |a Bachet, Jean-Baptiste |e verfasserin |4 aut | |
| 700 | 1 | |a Taieb, Julien |e verfasserin |4 aut | |
| 700 | 1 | |a Legoux, Jean-Louis |e verfasserin |4 aut | |
| 700 | 1 | |a De Gramont, Aimery |e verfasserin |4 aut | |
| 700 | 1 | |a Bennouna, Jaafar |e verfasserin |4 aut | |
| 700 | 1 | |a Bouché, Olivier |e verfasserin |4 aut | |
| 700 | 1 | |a Boussari, Olayide |e verfasserin |4 aut | |
| 700 | 1 | |a Manfredi, Sylvain |e verfasserin |4 aut | |
| 700 | 1 | |a Gornet, Jean-Marc |e verfasserin |4 aut | |
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