Relation of early tumor shrinkage (ETS) observed in first‐line treatment to efficacy parameters of subsequent treatment in FIRE‐3 (AIOKRK0306)
Relation of early tumor shrinkage (ETS) observed in first‐line treatment to efficacy parameters of subsequent treatment in FIRE‐3 (AIOKRK0306)
复制标题
FIRE-3 一线治疗中观察到的早期肿瘤缩小 (ETS) 与后续治疗疗效参数的关系 (AIOKRK0306)
DOI：
10.1002/ijc.30592
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发表时间：
2017
影响因子：
6.4
通讯作者：
V. Heinemann
中科院分区：
文献类型：
--
作者：
D. Modest;S. Stintzing;L. Fischer von Weikersthal;T. Decker;A. Kiani;U. Vehling‐Kaiser;S. Al;T. Heintges;C. Lerchenmüller;C. Kahl;G. Seipelt;F. Kullmann;W. Scheithauer;T. Kirchner;A. Jung;M. Stauch;J. V. von Einem;M. Moehler;S. Held;V. Heinemann
我们探讨了早期肿瘤缩小（ETS）和非 ETS 与 FIRE-3 治疗的 KRAS 野生型转移性结直肠癌患者一线和连续二线治疗的疗效之间的关系。肿瘤缩小的评估基于治疗 6 周后评估的目标病灶最长直径的总和。收缩分为ETS（收缩≥20%）、mETS（收缩0至<20%）、mPD（轻微进展>0至<20%）和PD（进展≥20%）。 ETS 患者的总生存期 (OS) 为 33.2 (95% CI 28.0–38.4) 个月，而非 ETS 患者的预后较差（mETS 24.0 (95% CI 21.2–26.9) 个月，mPD 19.0 (95% CI 13.0–25.0) 个月，PD 12.8 (95% CI) 11.1–14.5）个月）。一线治疗的 PFS 差异不太明显。一线治疗中定义的 ETS 亚组也与二线治疗的疗效相关。二线治疗（PFS2nd）的无进展生存期，ETS 为 6.5 个月（5.8-7.2），mETS 为 5.6（95% CI 4.7-6.5）个月，mPD 为 4.9（95% CI 3.7-6.1）个月，PD 为 3.3（95% CI 2.3-4.3）个月。一线和第二线的 PFS 显示线性相关（Bravais-Pearson 系数：0.16，p = 0.006）。虽然 ETS 与最有利的结果相关，但非 ETS 代表了一个异质亚组，其独特的特征是初始肿瘤对治疗的反应较差。这是首次分析证明一线 FOLFIRI 治疗期间观察到的早期肿瘤反应也可能与二线治疗的疗效相关。早期反应参数可以作为招募预先治疗患者的试验中的分层因素。
We explored the association of early tumor shrinkage (ETS) and non‐ETS with efficacy of first‐line and consecutive second‐line treatment in patients with KRAS wild‐type metastatic colorectal cancer treated in FIRE‐3. Assessment of tumor shrinkage was based on the sum of longest diameters of target lesions, evaluated after 6 weeks of treatment. Shrinkage was classified as ETS (shrinkage by ≥ 20%), mETS (shrinkage by 0 to <20%), mPD (minor progression >0 to <20%) and PD (progression ≥20%). Overall survival (OS) was 33.2 (95% CI 28.0–38.4) months in ETS patients, while non‐ETS was associated with less favorable outcome (mETS 24.0 (95% CI 21.2–26.9) months, mPD 19.0 (95% CI 13.0–25.0) months, PD 12.8 (95% CI 11.1–14.5) months). Differences in PFS of first‐line therapy were less pronounced. ETS subgroups defined in first‐line therapy also correlated with efficacy of second‐line therapy. Progression‐free survival in second‐line (PFS2nd) was 6.5 months (5.8–7.2) for ETS, and was 5.6 (95% CI 4.7–6.5) months for mETS, 4.9 (95% CI 3.7–6.1) months for mPD and 3.3 (95% CI 2.3–4.3) months for PD. PFS of first‐line and PFS2nd showed a linear correlation (Bravais–Pearson coefficient: 0.16, p = 0.006). While ETS is associated with the most favorable outcome, non‐ETS represents a heterogeneous subgroup with distinct characteristics of less favorable initial tumor response to treatment. This is the first analysis to demonstrate that early tumor response observed during first‐line FOLFIRI‐based therapy may also relate to efficacy of second‐line treatment. Early response parameters may serve as stratification factors in trials recruiting pretreated patients.