dc.contributor.author
Modest, Dominik Paul
dc.contributor.author
Heinemann, Volker
dc.contributor.author
Folprecht, Gunnar
dc.contributor.author
Denecke, Timm
dc.contributor.author
Pratschke, Johann
dc.contributor.author
Lang, Hauke
dc.contributor.author
Bemelmans, Marc
dc.contributor.author
Becker, Thomas
dc.contributor.author
Rentsch, Markus
dc.contributor.author
Seehofer, Daniel
dc.contributor.author
Bruns, Christiane J.
dc.contributor.author
Gebauer, Bernhard
dc.contributor.author
Held, Swantje
dc.contributor.author
Stahler, Arndt
dc.contributor.author
Heinrich, Kathrin
dc.contributor.author
Einem, Jobst C. von
dc.contributor.author
Stintzing, Sebastian
dc.contributor.author
Neumann, Ulf P.
dc.contributor.author
Ricard, Ingrid
dc.date.accessioned
2022-07-06T11:10:07Z
dc.date.available
2022-07-06T11:10:07Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/35494
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-35209
dc.description.abstract
Background: Tumor assessments after first-line therapy of RAS wild-type mCRC with cetuximab (cet) versus bevacizumab (bev) in combination with FOLFIRI were evaluated for factors influencing resectability, conversion to resectability, and survival after best response.
Methods: Conversion to resectability was defined as conversion of initially unresectable to resectable disease at best response as determined by retrospective assessment. Univariate and multivariate logistic models were fitted with resectability at best response as response variable. A Cox model comparing the survival from best response was used to measure the influence of treatment, resectability at best response, and resection. Interaction of resection and treatment arm on survival was tested by likelihood ratio test.
Results: Overall, 270 patients were evaluable (127 cet-arm, 143 bev-arm). Lung metastases (odds ratio [OR] 0.35, 95% confidence response [CI] 0.19-0.63), BRAF mutation (OR 0.33, 95% CI 0.12-0.82), and elevated alkaline phosphatase (OR 0.42, 95% CI 0.18-0.9) before randomization were associated with less chance of successful conversion and were integrated into a nomogram. Early tumor shrinkage (OR 1.86, 95% CI 1.06-3.3; p 0.034) and depth of response (OR 1.02, 95% CI 1.01-1.03; p < 0.001) were associated with successful conversion therapy. Resection of metastases improved post-best-response survival (hazard ratio 0.53, 95% CI 0.29-0.97; p = 0.039), predominantely in cet-treated patients (interaction test, p = 0.02).
Conclusions: Conversion to resectability is significantly associated with baseline characteristics that can be used in a nomogram to predict conversion. Moreover, early efficacy parameters (ETS and DpR) are associated with successful conversion therapy. In FIRE-3, resection of metastases was associated with improved post-best response survival, this effect originated predominantly from the cetuximab-based study arm.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
colorectal neoplasms
en
dc.subject
metastatic colorectal cancer
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Factors That Influence Conversion to Resectability and Survival After Resection of Metastases in RAS WT Metastatic Colorectal Cancer (mCRC): Analysis of FIRE-3- AIOKRK0306
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.doi
10.1245/s10434-020-08219-w
dcterms.bibliographicCitation.journaltitle
Annals of Surgical Oncology
dcterms.bibliographicCitation.originalpublishername
Springer Nature
dcterms.bibliographicCitation.pagestart
2389
dcterms.bibliographicCitation.pageend
2401
dcterms.bibliographicCitation.volume
27
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.funding
Springer Nature DEAL
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
32172334
dcterms.isPartOf.issn
1068-9265
dcterms.isPartOf.eissn
1534-4681