Pugh, S. A., Bowers, M., Ball, A., Falk, S., Finch-Jones, M., Valle, J. W., O'Reilly, D. A., Siriwardena, A. K., Hornbuckle, J., Rees, M., Rees, C., Iveson, T., Hickish, T., Maishman, T., Stanton, L., Dixon, E., Corkhill, A., Radford, M., Garden, O. J., Cunningham, D., Maughan, T. S., Bridgewater, J. A., Primrose, J. N. (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. ISSN 0007-0920

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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.

Item Type:	Article
Authors (ICR Faculty only):	Cunningham, David
All Authors:	Pugh, S. A., Bowers, M., Ball, A., Falk, S., Finch-Jones, M., Valle, J. W., O'Reilly, D. A., Siriwardena, A. K., Hornbuckle, J., Rees, M., Rees, C., Iveson, T., Hickish, T., Maishman, T., Stanton, L., Dixon, E., Corkhill, A., Radford, M., Garden, O. J., Cunningham, D., Maughan, T. S., Bridgewater, J. A., Primrose, J. N.
Additional Information:	ISI Document Delivery No.: DT2HZ Times Cited: 0 Cited Reference Count: 17 Pugh, Sian A. Bowers, Megan Ball, Alexandre Falk, Stephen Finch-Jones, Meg Valle, Juan W. O'Reilly, Derek A. Siriwardena, Ajith K. Hornbuckle, Joanne Rees, Myrddin Rees, Charlotte Iveson, Tim Hickish, Tamas Maishman, Tom Stanton, Louise Dixon, Elizabeth Corkhill, Andrea Radford, Mike Garden, O. James Cunningham, David Maughan, Tim S. Bridgewater, John A. Primrose, John N. Cancer Research UK; National Cancer Research Institute via National Cancer Research Network.; Merck KGaA, Darmstadt, Germany; National Institute for Health Research Biomedical Research Centres at University College London Hospitals; National Institute for Health Research Biomedical Research Centre (London, UK); Institute of Cancer Research (London, UK) The New EPOC study was funded by Cancer Research UK and supported by the National Cancer Research Institute via the National Cancer Research Network. This study was also supported by a medical grant from Merck KGaA, Darmstadt, Germany. JB is funded partly from the National Institute for Health Research Biomedical Research Centres at University College London Hospitals. DC is supported by the National Institute for Health Research Biomedical Research Centre based at the Royal Marsden Hospital and the Institute of Cancer Research (both in London, UK). 0 NATURE PUBLISHING GROUP LONDON BRIT J CANCER
Uncontrolled Keywords:	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
Research teams:	Clinical Units > Gastrointestinal Unit
Depositing User:	Barry Jenkins
Date Deposited:	12 Sep 2016 12:50
Last Modified:	12 Sep 2016 12:50
URI:	http://publications.icr.ac.uk/id/eprint/15280

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