Primary tumor location as a predictor of survival in patients with RAS wild-type colorectal cancer who receive molecularly targeted drugs as first-line therapy: a multicenter real-world observational study by the Japanese Society for Cancer of the Colon and Rectum

Takahiko Ito, Atsuo Takashima, Kentaro Yamazaki, Hiroki Yukami, Hiroyuki Uetake, Masahiro Tsuda, Takeshi Suto, Toshikazu Moriwaki, Naotoshi Sugimoto, Hitoshi Ojima, Yasumasa Takii, Hisateru Yasui, Taito Esaki, Akihito Tsuji, Masahiro Goto, Masayuki Saruta, Satoshi Otsu, Katsunori Shinozaki, Toshiyoshi Fujiwara, Takao TamuraEishi Baba, Manabu Shiozawa, Tadamichi Denda, Hideki Ueno, Kengo Nagashima, Yasuhiro Shimada

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Primary tumor location is considered a predictor of overall survival (OS) in RAS wild-type (WT) metastatic colorectal cancer (mCRC) treated with bevacizumab (BEV) or an anti-epidermal growth factor antibody (cetuximab or panitumumab [CET/PAN]) as first-line molecularly targeted therapy. BEV is recommended for right-sided mCRC and CET/PAN for left-sided mCRC based on post-hoc analyses of clinical trial data, but real-world evidence is lacking. Methods: We retrospectively collected data of patients who started BEV or CET/PAN plus 5-fluorouracil-based doublet chemotherapy between January 2013 and December 2016 as first-line treatment for RAS WT mCRC at any of 24 Japanese institutions. OS was compared between the BEV and CET/PAN groups according to primary tumor location by Cox multivariate regression analysis in the full cohort and in a propensity score-matched cohort. Results: In total, 935 patients were enrolled. Median OS was 24.6 months with BEV and 20.9 months with CET/PAN in right-sided mCRC (n = 213; adjusted hazard ratio [HR] 0.73, 95% confidence interval [CI] 0.50–1.06) and 35.7 months and 30.0 months, respectively, in left-sided mCRC (n = 722; adjusted HR 0.92, 95% CI 0.74–1.13). In the propensity score-matched cohort, OS was significantly better in the BEV group than in the CET/PAN group in right-sided mCRC (HR 0.52, 95% CI 0.28–0.96) but was not significantly different in left-sided mCRC (HR 0.78, 95% CI 0.53–1.07). Conclusion: Real-world data showed that OS was better with BEV than with CET/PAN in right-sided mCRC. However, there was no significant difference in OS in left-sided mCRC.

Original languageEnglish
Pages (from-to)1450-1458
Number of pages9
JournalInternational Journal of Clinical Oncology
Volume27
Issue number9
DOIs
Publication statusPublished - Sep 2022

Keywords

  • Bevacizumab
  • Cetuximab
  • Metastatic colorectal cancer
  • Panitumumab
  • Tumor sidedness

ASJC Scopus subject areas

  • Surgery
  • Hematology
  • Oncology

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