Predictive factors for early progression during induction chemotherapy and chemotherapy-free interval: analysis from PRODIGE 9 trial View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-02-04

AUTHORS

Thomas Aparicio, Jaafar Bennouna, Karine Le Malicot, Valérie Boige, Julien Taieb, Olivier Bouché, Jean-Marc Phelip, Eric François, Christian Borel, Roger Faroux, Laetitia Dahan, Jean-Baptiste Bachet, Joelle Egreteau, Marie-Christine Kaminsky, Jean-Marc Gornet, Oana Cojocarasu, Mohamed Gasmi, Véronique Guerin-Meyer, Côme Lepage, François Ghiringhelli,

ABSTRACT

BACKGROUND: Identifying patients with metastatic colorectal cancer who will have an early disease progression during induction chemotherapy (IC) and identifying patients who may have a chemotherapy-free interval (CFI) after IC are two major challenges. METHODS: A logistic model was used to identify factors associated with early progression during IC and with short duration of the first CFI in 488 patients enrolled in the PRODIGE 9 trial. Independent factors were defined with a threshold 0.10. RESULTS: In multivariate analysis, baseline leukocytes >10 × 109/L (OR = 1.98 [1.02-3.8], p = 0.04), and stable or increasing CEA at 2 months (OR = 3.61 [1.68-7.75], p = 0.01) were independent factors associated with progression during IC. Male gender (OR = 1.725 [0.92-3.325], p = 0.09) and no tumour response at first evaluation (OR = 1.90 [0.96-3.76], p = 0.07) were significantly associated with a short CFI. The presence of BRAF V600E mutation was also associated with short CFI (OR = 4.59 [0.95; 22.3], p = 0.058). CONCLUSION: High baseline leukocyte count and the lack of CEA decrease level at first evaluation were associated with early progression, and could be in favour of early chemotherapy intensification. Male gender, no tumour response at first evaluation and BRAF mutation are associated with a short CFI, and may be considered for maintenance chemotherapy after IC. CLINICAL TRIAL NUMBER: NCT00952029. More... »

PAGES

957-962

Journal

TITLE

British Journal of Cancer

ISSUE

7

VOLUME

122

Author Affiliations

  • Gastroenterology and Digestive Oncology Department, Hôpital Saint Louis, APHP.Nord, Université de Paris, Paris, France
  • Gastroenterology and Digestive Oncology Department, IMAD, Nantes University Hospital, Nantes, France
  • Fédération Francophone de Cancérologie Digestive (FFCD); Statistics Department, EPICAD INSERM LNC-UMR 1231, Université de Bourgogne et Franche Comté, Dijon, France
  • Medical Oncology Department, Gustave Roussy, Villejuif, France
  • Hepato-Gastroenterology and GI Oncology Department, Hôpital Européen Georges Pompidou, APHP, Université de Paris, Paris, France
  • Hepato-Gastroenterology Department, University Hospital Robert Debré, Reims, France
  • Hepato-Gastroenterology Department, Saint Etienne University Hospital, Hôpital Nord, Saint Priest en Jarez, France
  • Oncology Department, Antoine Lacassagne Center, Nice, France
  • Oncology Department, Paul Strauss Center, Strasbourg, France
  • Hepato-Gastroenterology Department, Hospital Les Oudairies, La Roche sur Yon, France
  • Hepato-Gastroenterology and Oncology Department, University Hospital la Timone, Marseille, France
  • Hepato-Gastroenterology Department, Hôpital Pitié-Salpêtrière, APHP, Sorbonne Université, Paris, France
  • Radiotherapy and Oncology Department, Centre Hospitalier Bretagne Sud, Lorient, France
  • Oncology Department, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
  • Onco-Hematology Department, Centre hospitalier du Mans, Le Mans, France
  • Hepato-Gastroenterology Department, Hôpital Nord, Marseille, France
  • Radiotherapy and Oncology Department, ICO Site Paul Papin, Angers, France
  • Hepato-Gastroenterology Department, University Hospital Le Bocage, EPICAD INSERM LNC-UMR 1231, Université de Bourgogne et Franche Comté, Dijon, France
  • Oncology Department, Centre Georges-François Leclerc, Dijon, France
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/s41416-020-0735-8

    DOI

    http://dx.doi.org/10.1038/s41416-020-0735-8

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1124551757

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/32015513


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        "description": "BACKGROUND: Identifying patients with metastatic colorectal cancer who will have an early disease progression during induction chemotherapy (IC) and identifying patients who may have a chemotherapy-free interval (CFI) after IC are two major challenges.\nMETHODS: A logistic model was used to identify factors associated with early progression during IC and with short duration of the first CFI in 488 patients enrolled in the PRODIGE 9 trial. Independent factors were defined with a threshold 0.10.\nRESULTS: In multivariate analysis, baseline leukocytes >10\u2009\u00d7\u2009109/L (OR\u2009=\u20091.98 [1.02-3.8], p\u2009=\u20090.04), and stable or increasing CEA at 2 months (OR\u2009=\u20093.61 [1.68-7.75], p\u2009=\u20090.01) were independent factors associated with progression during IC. Male gender (OR\u2009=\u20091.725 [0.92-3.325], p\u2009=\u20090.09) and no tumour response at first evaluation (OR\u2009=\u20091.90 [0.96-3.76], p\u2009=\u20090.07) were significantly associated with a short CFI. The presence of BRAF V600E mutation was also associated with short CFI (OR\u2009=\u20094.59 [0.95; 22.3], p\u2009=\u20090.058).\nCONCLUSION: High baseline leukocyte count and the lack of CEA decrease level at first evaluation were associated with early progression, and could be in favour of early chemotherapy intensification. Male gender, no tumour response at first evaluation and BRAF mutation are associated with a short CFI, and may be considered for maintenance chemotherapy after IC.\nCLINICAL TRIAL NUMBER: NCT00952029.", 
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    331 grid-institutes:grid.476348.a schema:alternateName Fédération Francophone de Cancérologie Digestive (FFCD); Statistics Department, EPICAD INSERM LNC-UMR 1231, Université de Bourgogne et Franche Comté, Dijon, France
    332 schema:name Fédération Francophone de Cancérologie Digestive (FFCD); Statistics Department, EPICAD INSERM LNC-UMR 1231, Université de Bourgogne et Franche Comté, Dijon, France
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    334 grid-institutes:grid.477443.7 schema:alternateName Radiotherapy and Oncology Department, Centre Hospitalier Bretagne Sud, Lorient, France
    335 schema:name Radiotherapy and Oncology Department, Centre Hospitalier Bretagne Sud, Lorient, France
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    337 grid-institutes:grid.508487.6 schema:alternateName Hepato-Gastroenterology and GI Oncology Department, Hôpital Européen Georges Pompidou, APHP, Université de Paris, Paris, France
    338 schema:name Hepato-Gastroenterology and GI Oncology Department, Hôpital Européen Georges Pompidou, APHP, Université de Paris, Paris, France
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