Impact de la latéralité de la tumeur primitive chez des patients atteints de cancer colorectal métastatique traités en 1ère ligne par Cétuximab : étude observationnelle, rétrospective, multicentrique

Abstract : Introduction: metastatic colorectal cancer has different characteristics depending on the location of the primary tumor. The objective of our study was to evaluate the prognostic impact of laterality in patients treated with cetuximab in the first line. Methods: EREBUS is a French multicenter cohort study, including initially unresectable mCRC patients treated with cetuximab in the first metastatic line. The analyzes were stratified according to the location of their primary tumor: right (from cecum to transverse colon) or left / rectum (downstream of splenic flexure). The outcome measures were 36-month overall survival, secondary resection rate of metastases, overall response rate at 24 months, and progression-free survival at 12 months. Results: a total of 248 patients were included (right colon (RCC): 55, left colon / rectum (LCC): 193). RCC were more often associated with BRAF mutation, peritoneal metastases, and anemia. Median overall survival was significantly longer in patients with LCC (29.1 months) compared with those with RCC (15.7 months) (p = 0.0007). Overall response rate was significantly higher in the LCC group (66.8% vs. 25.5%) (p <0.0001), as was the secondary metastases resection rate (35.8% in the LCC vs 14.6% in the RCC group, p = 0.0027). Progression-free survival was not different between the 2 groups. An ECOG score ≥2, anemia at diagnosis, a poorly differentiated tumor, the BRAF mutation and the absence of metastatic surgery were associated with a poorer prognosis. Conclusion: patients with RCC had shorter survival and lower rates of tumor response and metastasis resection compared to patients with CCRG. The tumor location also seemed to be predictive of the efficacy of cetuximab used in the first metastatic line.
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Master Thesis
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Submitted on : Monday, April 8, 2019 - 3:27:18 PM
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Fanny Hugonin-Roulet. Impact de la latéralité de la tumeur primitive chez des patients atteints de cancer colorectal métastatique traités en 1ère ligne par Cétuximab : étude observationnelle, rétrospective, multicentrique. Médecine humaine et pathologie. 2018. ⟨dumas-02092944⟩

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