[Comment] Transverse colon primary tumor location as a biomarker in metastatic colorectal cancer: a pooled analysis of CCTG/AGITG CO.17 and CO.20 randomized clinical trials
[Purpose] Sidedness is prognostic and predictive of anti-EGFR efficacy in metastatic colorectal cancer (mCRC). Transverse colon has been historically excluded from several analyses of sidedness and the optimal division between left-and right-sided colorectal cancer is unclear. We investigated transv...
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| Format: | Article |
| Language: | zho |
| Published: |
Editorial Office of Journal of Colorectal & Anal Surgery
2024-04-01
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| Series: | 结直肠肛门外科 |
| Subjects: | |
| Online Access: | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=151&cateName=2024%E5%B9%B4%20%E7%AC%AC30%E5%8D%B7%20%E7%AC%AC2%E6%9C%9F |
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| Summary: | [Purpose] Sidedness is prognostic and predictive of anti-EGFR efficacy in metastatic colorectal cancer (mCRC). Transverse colon has been historically excluded from several analyses of sidedness and the optimal division between left-and right-sided colorectal cancer is unclear. We investigated transverse colon primary tumor location as a biomarker in mCRC. [Experimental design] Pooled analysis of CCTG/AGITG CO. 17 and CO. 20 trials of cetuximab in chemotherapyrefractory mCRC. Outcomes of patients with RAS/BRAF wild-type (WT) mCRC from CO. 17 and KRAS WT mCRC from CO.20 were analyzed according to location. [Results] A total of 553 patients were analyzed, 32 (5.8%) with cancers from the transverse, 101 (18.3%) from right, and 420 from (75.9%) left colon. Transverse mCRC failed to reach significant benefit from cetuximab versus best supportive care (BSC) for overall survival [OS; median, 5.9 vs. 2.1 months; HR, 0.63;95% confidence interval (CI), 0.28-1.42; P＝0.26] and progression-free survival (PFS; median, 1.8 vs. 1.3 months; HR, 0.57; 95%CI, 0.26-1.28; P＝0.16). Analyzing exclusively patients randomized to cetuximab, right-sided and transverse had comparable outcomes for OS (median, 5.6 vs. 5.9 months; HR, 0.82; 95%CI, 0.50-1.34; P＝0.43) and PFS (median, 1.9 vs. 1.8 months; HR, 0.78; 95%CI, 0.49-1.26; P＝0.31). Patients with left-sided mCRC had superior outcomes with cetuximab compared with transverse for OS (median, 9.7 vs. 5.9 months; HR, 0.42; 95%CI, 0.27-0.67; P＝0.000 2) and PFS (median, 3.8 vs. 1.8 months; HR, 0, 49; 95%CI, 0.31-0.76; P＝0.001). Location was not prognostic in patients treated with BSC alone. [Conclusions] Transverse mCRC has comparable prognostic and predictive features with right-sided mCRC. |
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| ISSN: | 1674-0491 |