Impact of Delaying the Addition of Anti-EGFR in First Line of RAS Wild-Type Metastatic Colorectal Cancer: A Propensity-Weighted Pooled Data Analysis
Abstract
:Simple Summary
Abstract
1. Introduction
2. Methods
3. Results
3.1. Patients
3.2. Overall Survival
3.3. Progression-Free Survival
3.4. Objective Response Rate
3.5. Tumor Localization
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Survival According to Treatment Groups in the Unweighted Study Population
References
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Item | Overall | Immediate Anti-EGFR | Delayed Anti-EGFR | Immediate Anti-VEGF | Standardized Difference * | Missing (%) |
---|---|---|---|---|---|---|
Number of patients | 835 | 401 | 305 | 129 | ||
Age, median (range), years | 64.0 [56.6, 69.7] | 64.0 [56.6, 68.9] | 63.9 [56.5, 70.1] | 64.0 [57.3, 73.8] | 0.145 | 0.0 |
Sex | 0.126 | 0.0 | ||||
Men | 550 (65.9) | 278 (69.3) | 184 (60.3) | 88 (68.2) | ||
Women | 285 (34.1) | 123 (30.7) | 121 (39.7) | 41 (31.8) | ||
Tumor localization | 0.093 | 3.4 | ||||
Right/transverse | 150 (18.6) | 66 (17.1) | 64 (21.5) | 20 (16.1) | ||
Left/Rectum | 657 (81.4) | 320 (82.9) | 233 (78.5) | 104 (83.9) | ||
Primary tumor resected | 0.563 | 0.0 | ||||
No | 249 (29.8) | 66 (16.5) | 113 (37.0) | 70 (54.3) | ||
Yes | 586 (70.2) | 335 (83.5) | 192 (63.0) | 59 (45.7) | ||
Previous treatment | 0.251 | 0.0 | ||||
No | 557 (66.7) | 235 (58.6) | 224 (73.4) | 98 (76.0) | ||
Yes | 278 (33.3) | 166 (41.4) | 81 (26.6) | 31 (24.0) | ||
Metastases delay | 0.460 | 26.0 | ||||
Synchronous | 496 (80.3) | 222 (91.0) | 192 (78.4) | 82 (63.6) | ||
Metachronous | 122 (19.7) | 22 (9.0) | 53 (21.6) | 47 (36.4) | ||
Metastatic sites | 0.167 | 30.8 | ||||
1 | 280 (48.4) | 100 (45.0) | 125 (55.1) | 55 (42.6) | ||
>=2 | 298 (51.6) | 122 (55.0) | 102 (44.9) | 74 (57.4) | ||
Chemotherapy regimen | 0.257 | 0.1 | ||||
Oxaliplatin-based | 578 (69.3) | 263 (65.6) | 237 (78.0) | 78 (60.5) | ||
Irinotecan-based | 256 (30.7) | 138 (34.4) | 67 (22.0) | 51 (39.5) | ||
Country | NA | 0.0 | ||||
Czech Republic | 573 (68.6) | 401 (100.0) | 172 (56.4) | 0 (0.0) | ||
France | 262 (31.4) | 0 (0.0) | 133 (43.6) | 129 (100.0) |
Item | Overall | Immediate Anti-EGFR | Delayed Anti-EGFR | Immediate Anti-VEGF | Standardized Difference * | Missing (%) |
---|---|---|---|---|---|---|
Number of patients | 833 | 409 | 310 | 114 | ||
Age, years | 0.04 | 0.0 | ||||
<60 years | 445 (53.5) | 214 (52.3) | 168 (54.3) | 63 (55.4) | ||
≥60years | 388 (46.6) | 195 (47.7) | 142 (45.7) | 51 (44.6) | ||
Sex | 0.05 | 0.0 | ||||
Men | 542 (65.1) | 267 (65.3) | 205 (66.0) | 71 (62.1) | ||
Women | 291 (34.9) | 142 (34.7) | 105 (34.0) | 43 (38.0) | ||
Tumor localization | 0.07 | 0.0 | ||||
Right/transverse | 154 (18.5) | 72 (17.7) | 57 (18.2) | 25 (22.1) | ||
Left/Rectum | 679 (81.5) | 336 (82.3) | 253 (81.8) | 89 (78.0) | ||
Primary tumor resected | 0.07 | 0.0 | ||||
No | 259 (31.1) | 129 (31.5) | 91 (29.4) | 39 (34.0) | ||
Yes | 574 (68.9) | 280 (68.5) | 219 (70.6) | 75 (66.0) | ||
Previous treatment | 0.09 | 0.0 | ||||
No | 556 (66.8) | 271 (66.3) | 203 (65.5) | 82 (71.8) | ||
Yes | 277 (33.2) | 138 (33.7) | 107 (34.5) | 32 (28.2) | ||
Metastases delay | 0.09 | 0.0 | ||||
Synchronous | 617 (74.1) | 302 (73.9) | 235 (75.9) | 80 (70.0) | ||
Metachronous | 216 (25.9) | 107 (26.1) | 75 (24.1) | 34 (30.0) | ||
Metastatic sites | 0.09 | 0.0 | ||||
1 | 405 (48.6) | 201 (49.2) | 154 (49.7) | 49 (43.2) | ||
≥2 | 428 (51.4) | 208 (50.8) | 156 (50.3) | 65 (56.8) | ||
Chemotherapy regimen | 0.06 | 0.0 | ||||
Oxaliplatin-based | 594 (71.3) | 292 (71.3) | 218 (70.3) | 85 (74.1) | ||
Irinotecan-based | 239 (28.7) | 117 (28.7) | 92 (29.7) | 30 (25.9) |
Cox Models | ||||||
Delayed Versus Immediate Anti-EGFR | Immediate Anti-VEGF Versus Immediate Anti-EGFR | Immediate Anti-VEGF Versus Delayed Anti-EGFR | ||||
aHR (95%CI) | p | aHR (95%CI) | p | aHR (95%CI) | p | |
Overall survival | 0.78 [0.60–1.01] | 0.06 | 0.92 [0.69–1.24] | 0.61 | 1.19 [0.88–1.60] | 0.26 |
Right/transverse tumor | 1.03 [0.59–1.79] | 0.93 | 0.86 [0.45–1.64] | 0.64 | 0.83 [0.43–1.60] | 0.58 |
Left/Rectum tumor | 0.71 [0.53–0.97] | 0.03 | 0.89 [0.63–1.25] | 0.49 | 1.24 [0.87–1.75] | 0.23 |
Progression-free survival | 0.91 [0.75–1.10] | 0.32 | 0.93 [0.73–1.18] | 0.55 | 1.02 [0.80–1.31] | 0.83 |
Right/transverse tumor | 0.89 [0.57–1.40] | 0.62 | 0.84 [0.48–1.46] | 0.53 | 0.94 [0.53–1.64] | 0.82 |
Left/Rectum tumor | 0.91 [0.74–1.13] | 0.40 | 0.92 [0.70–1.21] | 0.57 | 1.01 [0.77–1.33] | 0.92 |
Logistic Regression Models | ||||||
Delayed Versus Immediate Anti-EGFR | Immediate Anti-Vegf Versus Immediate Anti-EGFR | Immediate Anti-VEGF Versus Delayed Anti-EGFR | ||||
aOR (95%CI) | p | aOR (95%CI) | p | aOR (95%CI) | p | |
Objective response rate | 1.75 [1.20–2.54] | 0.004 | 1.24 [0.71–2.19] | 0.45 | 0.71 [0.41–1.25] | 0.23 |
Right/transverse tumor | 1.69 [0.67–4.28] | 0.26 | 0.92 [0.21–3.98] | 0.91 | 0.54 [0.12–2.42] | 0.42 |
Left/Rectum tumor | 1.78 [1.17–2.68] | 0.007 | 1.38 [0.77–2.46] | 0.28 | 0.78 [0.43–1.40] | 0.40 |
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Palmieri, L.-J.; Buchler, T.; Meyer, A.; Veskrnova, V.; Fiala, O.; Brabec, P.; Baranova, J.; Coriat, R. Impact of Delaying the Addition of Anti-EGFR in First Line of RAS Wild-Type Metastatic Colorectal Cancer: A Propensity-Weighted Pooled Data Analysis. Cancers 2022, 14, 1410. https://doi.org/10.3390/cancers14061410
Palmieri L-J, Buchler T, Meyer A, Veskrnova V, Fiala O, Brabec P, Baranova J, Coriat R. Impact of Delaying the Addition of Anti-EGFR in First Line of RAS Wild-Type Metastatic Colorectal Cancer: A Propensity-Weighted Pooled Data Analysis. Cancers. 2022; 14(6):1410. https://doi.org/10.3390/cancers14061410
Chicago/Turabian StylePalmieri, Lola-Jade, Tomas Buchler, Antoine Meyer, Veronika Veskrnova, Ondrej Fiala, Petr Brabec, Jana Baranova, and Romain Coriat. 2022. "Impact of Delaying the Addition of Anti-EGFR in First Line of RAS Wild-Type Metastatic Colorectal Cancer: A Propensity-Weighted Pooled Data Analysis" Cancers 14, no. 6: 1410. https://doi.org/10.3390/cancers14061410