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

Pugh, SA; Bowers, M; Ball, A; Falk, S; Finch-Jones, M; Valle, JW; O'Reilly, DA; ... Primrose, JN; + view all (2016) Patterns of progression, treatment of progressive disease and post-progression survival in the New EPOC study. British Journal of Cancer , 115 (4) pp. 420-424. 10.1038/bjc.2016.208. Green open access

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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.

Type: Article
Title: Patterns of progression, treatment of progressive disease and post-progression survival in the New EPOC study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1038/bjc.2016.208
Publisher version: http://dx.doi.org/10.1038/bjc.2016.208
Language: English
Additional information: This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License.
Keywords: Science & Technology, Life Sciences & Biomedicine, Oncology, colorectal liver metastases, colorectal cancer, cetuximab, epidermal growth factor inhibition, chemotherapy, liver resection, progressive disease, cancer research UK, METASTATIC COLORECTAL-CANCER, RESECTABLE LIVER METASTASES, RANDOMIZED CONTROLLED-TRIAL, REPEAT HEPATECTOMY, SURGERY, CHEMOTHERAPY, 5-FLUOROURACIL, OXALIPLATIN, LEUCOVORIN, CETUXIMAB
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Haematology
URI: https://discovery.ucl.ac.uk/id/eprint/1514925
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