ECCO 15 and ESMO 34 Sep 20-24, 2009. OMIT Bretagne /Pays de la Loire. Management of unresectable metastatic colorectal cancer (MCRC) in the real world with successive regimens with targeted therapies (bevacizumab and cetuximab) : the experience of the OMIT Bretagne Pays de la Loire.
ECCO 15 and ESMO 34
Sep 20-24, 2009
OMIT Bretagne /Pays de la Loire
Management of unresectable metastatic colorectal cancer (MCRC) in the real world with successive regimens with targeted therapies (bevacizumab and cetuximab) : the experience of the OMIT Bretagne Pays de la Loire
JP Metges ([email protected]), E Gamelin, JY Douillard, G Ganem, R Faroux,
P Deguiral, V Klein, JF Ramée, C Riché, S Traoré, F Grudé ([email protected])
In Europe, combinations of targeted cancer therapies and conventional chemotherapies, more precisely bevacizumab-Folfiri and cetuximab-irinotecan, have been used as successive regimens in unresectable MCRC since 2006. The OMIT BPL analysed the impact of bevacizumab-Folfiri as first line treatment and cetuximab-based regimens as second or further line treatment on a cohort of unselected patients in usual clinical pratice.
3 patients stopped bevacuzimab-Folfiri due to:
- Gastrointestinal toxicity + high blood pressure (2)
- Phlebitis (1)
2 patients stopped Cetuximab-Folfiri due to:
- Cutaneous toxicity (1)
- Cutaneous toxicity + gastrointestinal toxicity (1)
PROGRESSION FREE SURVIVAL
The median of progression free survival (PFS) for patients treated with bevacizumab and cetuximab was 17.51 months IC 95% [12,86 - 22,16]. The medians of PFS from initiation to the stopping date of bevacizumab and from initiation to the stopping date of cetuximab were respectively 6.87 months IC 95 % [4.75 - 8.98] and 5.06 months IC 95 % [3.49 - 6.63].
OVERALL SURVIVAL (+/- resection)
The median overall survival for bevacizumab + cetuximab therapy was 27.33 months IC 95% [23.80 - 30.87] and after initiation of cetuximab therapy was 16.33 months IC 95 % [11.84 - 20.82].
The three-year survival probability for the patients who underwent metastasis resection after Folfiri-bevacizumab was 86 % vs 44 % for the patients who did not (p<0.0079 by the log-rank test) and the median overall survival for the patients who underwent metastases resection after Folfiri-bevacuzimab was not reached vs 24.08 months [19.23-28.93] for the patients who did not.
WHAT DID THE PATIENTS RECEIVE AFTER ?
We present the results, obtained from OMIT BPL database, concerning patients treated successively by Folfiri-bevacizumab and cetuximab-based regimens. We observed that the patients who underwent metastasis resection after Folfiri-bevacizumab had an overall survival significantly improved compared to those who did not.
This study is ongoing and is expected to enroll approximatively 150 patients.
Acknowledgments For Private and public hospitals in Bretagne and Pays de la Loire: For clinicians, pharmacists, Directors
CHU Brest, CLCC Paul Papin Angers, CLCC René Gauducheau Nantes, Centre Jean Bernard Le Mans, CH La Roche-sur-Yon, Pôle Hospitalier mutualiste Saint-Nazaire, Clinique Océane Vannes, Centre Catherine Sienne Nantes, CH Laval, CH Le Mans, CLCC Eugène Marquis Rennes, CH St Malo, CH Château Gontier, CHU Hôtel Dieu Nantes, CH Morlaix, CH Quimper, Clinique Armoricaine Saint-Brieuc, Polyclinique Parc Cholet
Brigitte Lemarquand Scientific researcher, Aude de Fallois Clincal Research Associate