TY - JOUR
T1 - Clinical impact of first-line bevacizumab plus chemotherapy in metastatic colorectal cancer of mucinous histology
T2 - a multicenter, retrospective analysis on 685 patients
AU - Catalano, Vincenzo
AU - Bergamo, Francesca
AU - Cremolini, Chiara
AU - Vincenzi, Bruno
AU - Negri, Francesca
AU - Giordani, Paolo
AU - Alessandroni, Paolo
AU - Intini, Rossana
AU - Stragliotto, Silvia
AU - Rossini, Daniele
AU - Borelli, Beatrice
AU - Santini, Daniele
AU - Sarti, Donatella
AU - Rocchi, Marco B L
AU - Lonardi, Sara
AU - Falcone, Alfredo
AU - Zagonel, Vittorina
AU - Mattioli, Rodolfo
AU - Graziano, Francesco
PY - 2020/2
Y1 - 2020/2
N2 - 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.
AB - 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.
KW - Adenocarcinoma, Mucinous/drug therapy
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
KW - Bevacizumab/therapeutic use
KW - Camptothecin/analogs & derivatives
KW - Colorectal Neoplasms/drug therapy
KW - Female
KW - Fluorouracil/therapeutic use
KW - Humans
KW - Irinotecan/therapeutic use
KW - Leucovorin/therapeutic use
KW - Male
KW - Middle Aged
KW - Organoplatinum Compounds/therapeutic use
KW - Oxaliplatin/therapeutic use
KW - Prognosis
KW - Retrospective Studies
U2 - 10.1007/s00432-019-03077-w
DO - 10.1007/s00432-019-03077-w
M3 - Article
C2 - 31691872
VL - 146
SP - 493
EP - 501
JO - Journal of Cancer Research and Clinical Oncology
JF - Journal of Cancer Research and Clinical Oncology
SN - 0171-5216
IS - 2
ER -