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, 6 (3), 231-6

Anti-epidermal or Anti-Vascular Endothelial Growth Factor as First-Line Metastatic Colorectal Cancer in Modified Glasgow Prognostic Score 2' Patients

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Anti-epidermal or Anti-Vascular Endothelial Growth Factor as First-Line Metastatic Colorectal Cancer in Modified Glasgow Prognostic Score 2' Patients

Johann Dréanic et al. J Cachexia Sarcopenia Muscle.

Abstract

Background: In metastatic colorectal cancer, the modified Glasgow prognostic score (mGPS) has been approved as an independent prognostic indicator of survival. No data existed on poor prognosis patients treated with molecular-targeted agents.

Methods: From January 2007 to February 2012, patients with metastatic colorectal cancer and poor predictive survival score (mGPS = 2), treated with 5-fluorouracil-based chemotherapy in addition to an anti-epidermal growth factor receptor (EGFR) or anti-vascular epidermal growth factor (VEGF) therapy, were included to assess the interest of targeted therapy within mGPS = 2' patients.

Results: A total of 27 mGPS = 2' patients were included and received a 5-fluorouracil-based systemic chemotherapy in addition to an anti-EGFR treatment (cetuximab; n = 18) or an anti-VEGF treatment (bevacizumab; n = 9). Median follow-up was 12.1 months (interquartile range 4.9-22). Patients were Eastern Cooperative Oncology Group (ECOG) Performance Status 1, 2, and 3 in 66% (n = 18), 26% (n = 7), and 8% (n = 2), respectively. Comparing anti-EGFR and anti-VEGF groups, median progression-free survival was 3.9 and 15.4 months, respectively, and was significantly different (P = 0.046). Conversely, the median overall survival was not significantly different between the two groups (P = 0.15).

Conclusion: Our study confirmed the poor survival of patients with mGPS = 2 despite the use of targeted therapy and identified the superiority of an anti-VEGF treatment in progression-free survival, without a significant benefit in the overall survival compared with the anti-EGFR therapy. Our results deserved confirmation by a prospective clinical trial.

Keywords: Bevacizumab; C-reactive protein; Cetuximab; Colorectal cancer; Epidermal growth factor receptor; Glasgow prognostic score; Targeted therapy; Vascular epithelial growth factor.

Figures

Figure 1
Figure 1
Progression-free survival in anti-epidermal growth factor receptor and anti-vascular epidermal growth factor groups.
Figure 2
Figure 2
Overall survival in anti-epidermal growth factor receptor and anti-vascular epidermal growth factor groups.

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