Patterns of progression, treatment of progressive disease and post-progression survival in the New EPOC study

Siân A Pugh, Megan Bowers, Alexandre Ball, Stephen Falk, Meg Finch-Jones, Juan W Valle, Derek A O'Reilly, Ajith K Siriwardena, Joanne Hornbuckle, Myrddin Rees, Charlotte Rees, Tim Iveson, Tamas Hickish, Tom Maishman, Louise Stanton, Elizabeth Dixon, Andrea Corkhill, Mike Radford, O James Garden, David CunninghamTim S Maughan, John A Bridgewater, John N Primrose

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The addition of cetuximab (CTX) to perioperative chemotherapy (CT) for operable colorectal liver metastases resulted in a shorter progression-free survival. Details of disease progression are described to further inform the primary study outcome.

METHODS: A total of 257 KRAS wild-type patients were randomised to CT alone or CT with CTX. Data regarding sites and treatment of progressive disease were obtained for the 109 (CT n=48, CT and CTX n=61) patients with progressive disease at the cut-off date for analysis of November 2012.

RESULTS: The liver was the most frequent site of progression (CT 67% (32/48); CT and CTX 66% (40/61)). A higher proportion of patients in the CT and group had multiple sites of progressive disease (CT 8%, 4/48; CT and CTX 23%, 14/61 P=0.04). Further treatment for progressive disease is known for 84 patients of whom 69 received further CT, most frequently irinotecan based. Twenty-two patients, 11 in each arm, received CTX as a further line agent.

CONCLUSIONS: Both the distribution of progressive disease and further treatment are as expected for such a cohort. The pattern of disease progression seen is consistent with failure of systemic micrometastatic disease control rather than failure of local disease control following liver surgery.

Original languageEnglish
Pages (from-to)420-4
Number of pages5
JournalBritish Journal of Cancer
Volume115
Issue number4
DOIs
Publication statusPublished - 9 Aug 2016

Keywords

  • Journal Article

Research Beacons, Institutes and Platforms

  • Manchester Cancer Research Centre

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