Histological response, pattern of tumor destruction and clinical outcome after neoadjuvant chemotherapy including bevacizumab or cetuximab in patients undergoing liver resection for colorectal liver metastases. Issue 7 (July 2015)

• Record Type: Journal Article
• Authors: Stremitzer, S.; Stift, J.; Singh, J.; Starlinger, P.; Gruenberger, B.; Tamandl, D.; Gruenberger, T.
• Is Part Of: European journal of surgical oncology. Volume 41:Issue 7(2015:Jul.)
• Page Start: 868
• Page End: 874
• Publication Date: 2015-07
• Subjects: Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2015.03.223
• Languages: English
• ISSNs: 0748-7983

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Aim</title> <p id="abspara0010">We investigated whether the type of antibody [bevacizumab (bev) or cetuximab (cet)] added to neoadjuvant combination chemotherapy before curative liver resection was associated with histological response, the pattern of tumor destruction and clinical outcome in patients with colorectal liver metastases (CLM).</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">We investigated 138 patients with <italic>KRAS</italic> wild-type status (codon 12, 13 and 61) who received neoadjuvant chemotherapy including bev (n = 101) or cet (n = 37). The primary endpoint was histological response. Secondary endpoints were necrosis and fibrosis of metastases, radiological response, recurrence-free survival (RFS) and overall survival (OS).</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">Histological response was not significantly different between the two groups (<italic>P</italic> = 0.19). A significantly higher fraction of patients in the bev group showed necrosis of the metastases of ≥50% (<italic>P</italic> < 0.001), while a higher fraction of patients in the cet group showed fibrosis of ≥40% (<italic>P</italic> = 0.030). Radiological response was not significantly different (<italic>P</italic> = 0.17). Median RFS was significantly shorter in the cet group in univariable analysis (HR 1.59 (95% CI 1.00, 2.51), <italic>P</italic> = 0.049), but this difference did not remain significant in multivariable analysis (<italic>P</italic> = 0.45). The 3-year OS rate was not significantly different (<italic>P</italic> = 0.73).</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">The addition of bevacizumab to combination chemotherapy showed more necrosis but less fibrosis of metastases compared to cetuximab and a trend towards higher histological and radiological response and longer RFS. Further investigations of biological tumor characteristics are required to individualize treatment combinations.</p> </sec> </abstract>