[Comment] Efficacy of FOLFIRI plus cetuximab vs FOLFIRI plus bevacizumab in 1st-line treatment of older pa tients with RAS wild-type metastatic colorectal cancer:an analysis of the randomised trial FIRE-3
[Background] The evidence on the efficacy of anticancer therapy is limited in older patients with metastatic colorectal cancer (mCRC). This retrospective analysis of phase III FIRE-3 trial assesses the efficacy of FOLFIRI plus either cetuximab or bevacizumab according to the patients' age and s...
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| Language: | zho |
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Editorial Office of Journal of Colorectal & Anal Surgery
2022-08-01
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| Series: | 结直肠肛门外科 |
| Online Access: | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=394&cateName=2022%E5%B9%B4%20%E7%AC%AC28%E5%8D%B7%20%E7%AC%AC4%E6%9C%9F |
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| author | Wu Deqing |
| author_facet | Wu Deqing |
| author_sort | Wu Deqing |
| collection | DOAJ |
| description | [Background] The evidence on the efficacy of anticancer therapy is limited in older patients with metastatic colorectal cancer (mCRC). This retrospective analysis of phase III FIRE-3 trial assesses the efficacy of FOLFIRI plus either cetuximab or bevacizumab according to the patients' age and sidedness of primary tumour. [Methods] The study endpoints overall response rate (ORR), progression-free survival (PFS) and overall survival (OS) were compared between younger (<65 years) and older (≥65 years) patients, followed by stratification according to primary tumour sidedness. ORR was compared using Fisher´s exact test, OS and PFS were estimated by the Kaplan-Meier method and compared using the log-rank test. Univariate Cox regression analyses assessed hazard ratios and 95% confidence intervals for OS and PFS. [Results] Overall, older patients with RAS WT tumours had a significantly shorter OS when compared to younger patients (25.9 months vs 29.3 months, HR 1.29; P = 0.02). Also the proportion of right-sided tumours was significantly greater in older patients (27.1% vs 17.9%; P = 0.029). Secondary resection rates were numerically higher in younger patients (25.4% vs. 17.6%, P = 0.068) than in older patients. This was primarily seen in the Cetuximab arm, where older patients underwent less likely resection (13.1% vs. 26%; P = 0.02). Older patients with left-sided tumours showed only a trend towards greater efficacy of cetuximab (HR 0.86; P = 0.38). In patients with right-sided primary tumours, older patients did not appear to benefit from cetuximab in contrast to younger patients (≥65 years: 16.6 months vs 23.6 months, HR 1.1; P = 0.87; <65 years: 21.9 months vs 16.4 months HR 1.5; P = 0.31). [Conclusions] In FIRE-3, OS was generally shorter in older patients in comparison to younger patients. This could be explained by the overrepresentation of right-sided tumours and a lower secondary resection rate in older patients. The efficacy of targeted therapy was dependent on tumour sidedness in older patients with RAS WT mCRC. |
| format | Article |
| id | doaj-art-ceb557da717243e98328744ccaaa87ef |
| institution | Kabale University |
| issn | 1674-0491 |
| language | zho |
| publishDate | 2022-08-01 |
| publisher | Editorial Office of Journal of Colorectal & Anal Surgery |
| record_format | Article |
| series | 结直肠肛门外科 |
| spelling | doaj-art-ceb557da717243e98328744ccaaa87ef2025-08-20T03:28:48ZzhoEditorial Office of Journal of Colorectal & Anal Surgery结直肠肛门外科1674-04912022-08-0128441141210.19668/j.cnki.issn1674-0491.2022.04.023[Comment] Efficacy of FOLFIRI plus cetuximab vs FOLFIRI plus bevacizumab in 1st-line treatment of older pa tients with RAS wild-type metastatic colorectal cancer:an analysis of the randomised trial FIRE-3Wu Deqing0Department of Gastrointestinal Surgery, Guangdong Provincial People's Hospital, Guangdong 510030, Guangzhou, China[Background] The evidence on the efficacy of anticancer therapy is limited in older patients with metastatic colorectal cancer (mCRC). This retrospective analysis of phase III FIRE-3 trial assesses the efficacy of FOLFIRI plus either cetuximab or bevacizumab according to the patients' age and sidedness of primary tumour. [Methods] The study endpoints overall response rate (ORR), progression-free survival (PFS) and overall survival (OS) were compared between younger (<65 years) and older (≥65 years) patients, followed by stratification according to primary tumour sidedness. ORR was compared using Fisher´s exact test, OS and PFS were estimated by the Kaplan-Meier method and compared using the log-rank test. Univariate Cox regression analyses assessed hazard ratios and 95% confidence intervals for OS and PFS. [Results] Overall, older patients with RAS WT tumours had a significantly shorter OS when compared to younger patients (25.9 months vs 29.3 months, HR 1.29; P = 0.02). Also the proportion of right-sided tumours was significantly greater in older patients (27.1% vs 17.9%; P = 0.029). Secondary resection rates were numerically higher in younger patients (25.4% vs. 17.6%, P = 0.068) than in older patients. This was primarily seen in the Cetuximab arm, where older patients underwent less likely resection (13.1% vs. 26%; P = 0.02). Older patients with left-sided tumours showed only a trend towards greater efficacy of cetuximab (HR 0.86; P = 0.38). In patients with right-sided primary tumours, older patients did not appear to benefit from cetuximab in contrast to younger patients (≥65 years: 16.6 months vs 23.6 months, HR 1.1; P = 0.87; <65 years: 21.9 months vs 16.4 months HR 1.5; P = 0.31). [Conclusions] In FIRE-3, OS was generally shorter in older patients in comparison to younger patients. This could be explained by the overrepresentation of right-sided tumours and a lower secondary resection rate in older patients. The efficacy of targeted therapy was dependent on tumour sidedness in older patients with RAS WT mCRC.https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=394&cateName=2022%E5%B9%B4%20%E7%AC%AC28%E5%8D%B7%20%E7%AC%AC4%E6%9C%9F |
| spellingShingle | Wu Deqing [Comment] Efficacy of FOLFIRI plus cetuximab vs FOLFIRI plus bevacizumab in 1st-line treatment of older pa tients with RAS wild-type metastatic colorectal cancer:an analysis of the randomised trial FIRE-3 结直肠肛门外科 |
| title | [Comment] Efficacy of FOLFIRI plus cetuximab vs FOLFIRI plus bevacizumab in 1st-line treatment of older pa tients with RAS wild-type metastatic colorectal cancer:an analysis of the randomised trial FIRE-3 |
| title_full | [Comment] Efficacy of FOLFIRI plus cetuximab vs FOLFIRI plus bevacizumab in 1st-line treatment of older pa tients with RAS wild-type metastatic colorectal cancer:an analysis of the randomised trial FIRE-3 |
| title_fullStr | [Comment] Efficacy of FOLFIRI plus cetuximab vs FOLFIRI plus bevacizumab in 1st-line treatment of older pa tients with RAS wild-type metastatic colorectal cancer:an analysis of the randomised trial FIRE-3 |
| title_full_unstemmed | [Comment] Efficacy of FOLFIRI plus cetuximab vs FOLFIRI plus bevacizumab in 1st-line treatment of older pa tients with RAS wild-type metastatic colorectal cancer:an analysis of the randomised trial FIRE-3 |
| title_short | [Comment] Efficacy of FOLFIRI plus cetuximab vs FOLFIRI plus bevacizumab in 1st-line treatment of older pa tients with RAS wild-type metastatic colorectal cancer:an analysis of the randomised trial FIRE-3 |
| title_sort | comment efficacy of folfiri plus cetuximab vs folfiri plus bevacizumab in 1st line treatment of older pa tients with ras wild type metastatic colorectal cancer an analysis of the randomised trial fire 3 |
| url | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=394&cateName=2022%E5%B9%B4%20%E7%AC%AC28%E5%8D%B7%20%E7%AC%AC4%E6%9C%9F |
| work_keys_str_mv | AT wudeqing commentefficacyoffolfiripluscetuximabvsfolfiriplusbevacizumabin1stlinetreatmentofolderpatientswithraswildtypemetastaticcolorectalcancerananalysisoftherandomisedtrialfire3 |