Clinical impact of first-line bevacizumab plus chemotherapy in metastatic colorectal cancer of mucinous histology: a multicenter, retrospective analysis on 685 patients

Vincenzo Catalano, Francesca Bergamo, Chiara Cremolini, Bruno Vincenzi, Francesca Negri, Paolo Giordani, Paolo Alessandroni, Rossana Intini, Silvia Stragliotto, Daniele Rossini, Beatrice Borelli, Daniele Santini, Donatella Sarti, Marco B L Rocchi, Sara Lonardi, Alfredo Falcone, Vittorina Zagonel, Rodolfo Mattioli, Francesco Graziano

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: In metastatic colorectal cancer (MCRC), mucinous histology has been associated with poor response rate and prognosis. We investigated whether bevacizumab combined with different chemotherapy regimens may have an impact on clinical outcomes of MCRC patients with mucinous histology.

METHODS: 685 MCRC patients were classified in mucinous adenocarcinoma (MC) and non-mucinous adenocarcinoma (NMC) and were treated with first-line bevacizumab plus fluoropyrimidine (FP)-based, oxaliplatin (OXA)-based, irinotecan (IRI)-based, or FOLFOXIRI.

RESULTS: Ninety-four (13.7%) patients had MC. With a median follow-up of 50 months, MC patients had a median overall survival (OS) of 28.2 months compared with 27.7 months for the NMC group [hazard ratio (HR) = 0.92; 95% confidence interval (CI) 0.70-1.19, P = 0.530]. The overall response rates for MC and NMC were 41.5% (95% CI 31.5-51.4) and 62.4% (95% CI 58.4-66.3), respectively (Chi-square test, P <0.003). After correcting for significant prognostic factors by multivariate Cox regression analysis, age, resection of the primary tumour, and number of metastatic sites were found to be associated with poorer OS, but not mucinous histology.

CONCLUSION: Compared with NMC, MCRC patients with mucinous histology treated with bevacizumab plus chemotherapy had comparable OS despite lower overall response rate.

Original languageEnglish
Pages (from-to)493-501
Number of pages9
JournalJournal of Cancer Research and Clinical Oncology
Volume146
Issue number2
Early online dateNov 6 2019
DOIs
Publication statusPublished - Feb 2020

Keywords

  • Adenocarcinoma, Mucinous/drug therapy
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols/therapeutic use
  • Bevacizumab/therapeutic use
  • Camptothecin/analogs & derivatives
  • Colorectal Neoplasms/drug therapy
  • Female
  • Fluorouracil/therapeutic use
  • Humans
  • Irinotecan/therapeutic use
  • Leucovorin/therapeutic use
  • Male
  • Middle Aged
  • Organoplatinum Compounds/therapeutic use
  • Oxaliplatin/therapeutic use
  • Prognosis
  • Retrospective Studies

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