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Clinicopathological factors influencing outcome in metastatic colorectal cancer patients treated with fluoropyrimidine and bevacizumab maintenance treatment vs observation: an individual patient data meta-analysis of two phase 3 trials

dc.contributor.authorGoey, KK
dc.contributor.authorElias, SG
dc.contributor.authorHinke, A
dc.contributor.authorvan Oijen, MG
dc.contributor.authorPunt, CJ
dc.contributor.authorHegewisch-Becker, S
dc.contributor.authorArnold, D
dc.contributor.authorKoopman, M
dc.date.accessioned2018-05-31T22:01:07Z
dc.date.available2018-05-31T22:01:07Z
dc.date.issued2017-12-05
dc.description.abstractBACKGROUND: The CAIRO3 and AIO 0207 trials demonstrated the efficacy of fluoropyrimidine plus bevacizumab (FP+Bev) maintenance treatment in metastatic colorectal cancer (mCRC) patients. In this individual patient data meta-analysis with updated follow-up, we aim to provide more precise estimates of treatment effects and to identify subgroups that benefit most from maintenance treatment or observation. METHODS: In 871 patients, randomised to FP+Bev maintenance treatment or observation, we investigated whether treatment effect was modified by sex, age, performance status, response to induction treatment, primary tumour location, number of metastatic sites, disease stage and primary tumour resection, serum LDH, platelet count, CEA, and RAS/BRAF mutation status. Primary end point was time to second progression after reintroduction of the induction regimen (PFS2). Secondary end points were first progression-free survival (PFS1) and overall survival (OS). RESULTS: At a median follow-up of 68.5 months (IQR 54.6-87.0 months), maintenance treatment was more effective compared with observation in PFS1 (HR 0.40(95% CI 0.34-0.47)) and PFS2 (HR 0.70(0.60-0.81)). No subgroups were identified that did not benefit from maintenance treatment in PFS1 and PFS2; no clinically relevant subgroup effects were observed. Regarding OS, pooled results were not significant (HR 0.91(0.78-1.05)), and the trials showed marked heterogeneity in overall treatment effect and subgroup effects. CONCLUSIONS: FP+Bev maintenance treatment is effective in all patients, regardless of the investigated subgroups.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationBr J Cancer. 2017 Dec 5;117(12):1768-1776.pt_PT
dc.identifier.doi10.1038/bjc.2017.382pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.26/23017
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectAdenocarcinomapt_PT
dc.subjectNeoplasias Colorretaispt_PT
dc.subjectProtocolos de Quimioterapia Combinada Antineoplásicapt_PT
dc.subjectBevacizumabpt_PT
dc.subjectCapecitabinapt_PT
dc.subjectConduta Expectantept_PT
dc.subjectCapecitabinept_PT
dc.subjectWatchful Waitingpt_PT
dc.subjectAntineoplastic Combined Chemotherapy Protocolspt_PT
dc.subjectColorectal Neoplasmspt_PT
dc.titleClinicopathological factors influencing outcome in metastatic colorectal cancer patients treated with fluoropyrimidine and bevacizumab maintenance treatment vs observation: an individual patient data meta-analysis of two phase 3 trialspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1776pt_PT
oaire.citation.issue12pt_PT
oaire.citation.startPage1768-1776pt_PT
oaire.citation.volume117pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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