Patterns of progression, treatment of progressive disease and post-progression survival in the New EPOC study.
Patterns of progression, treatment of progressive disease and post-progression survival in the New EPOC study.
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DOI：
10.1038/bjc.2016.208
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发表时间：
2016-08-09
影响因子：
8.8
通讯作者：
Primrose JN
中科院分区：
文献类型：
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作者：
Pugh SA;Bowers M;Ball A;Falk S;Finch-Jones M;Valle JW;O'Reilly DA;Siriwardena AK;Hornbuckle J;Rees M;Rees C;Iveson T;Hickish T;Maishman T;Stanton L;Dixon E;Corkhill A;Radford M;Garden OJ;Cunningham D;Maughan TS;Bridgewater JA;Primrose JN
西妥昔单抗（CTX）加围手术期化疗（CT）可手术结直肠肝转移导致更短的无进展生存期。描述了疾病进展的详细信息，以进一步了解主要研究结局。共有257例KRAS野生型患者随机接受单独CT或CT联合CTX治疗。在分析截止日期2012年11月，获得了109例（CT n=48，CT和CTX n=61）疾病进展患者的研究中心和疾病进展治疗相关数据。肝脏是最常见的进展部位（CT 67%（32/48）; CT和CTX 66%（40/61））。CT和组中有较高比例的患者有多个部位的疾病进展（CT 8%，4/48; CT和CTX 23%，14/61 P=0.04）。已知84例患者接受了进一步的疾病进展治疗，其中69例接受了进一步的CT，最常见的是基于伊立替康。22例患者，每组11例，接受CTX作为进一步的一线药物。进展性疾病的分布和进一步治疗均符合此类队列的预期。观察到的疾病进展模式与肝脏手术后全身微转移疾病控制失败而非局部疾病控制失败一致。
The addition of cetuximab (CTX) to perioperative chemotherapy (CT) for operable colorectal liver metastases resulted in a shorter progression-free survival. Details of disease progression are described to further inform the primary study outcome. A total of 257 KRAS wild-type patients were randomised to CT alone or CT with CTX. Data regarding sites and treatment of progressive disease were obtained for the 109 (CT n=48, CT and CTX n=61) patients with progressive disease at the cut-off date for analysis of November 2012. The liver was the most frequent site of progression (CT 67% (32/48); CT and CTX 66% (40/61)). A higher proportion of patients in the CT and group had multiple sites of progressive disease (CT 8%, 4/48; CT and CTX 23%, 14/61 P=0.04). Further treatment for progressive disease is known for 84 patients of whom 69 received further CT, most frequently irinotecan based. Twenty-two patients, 11 in each arm, received CTX as a further line agent. Both the distribution of progressive disease and further treatment are as expected for such a cohort. The pattern of disease progression seen is consistent with failure of systemic micrometastatic disease control rather than failure of local disease control following liver surgery.