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

Patterns of progression, treatment of progressive disease and post-progression survival in the New EPOC study
Patterns of progression, treatment of progressive disease and post-progression survival in the New EPOC study
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.
0007-0920
420-424
Pugh, Sian A.
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Bowers, Megan
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Ball, Alexandre
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Falk, Stephen
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Finch-Jones, Meg
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Valle, Juan W.
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O'Reilly, Derek A.
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Siriwardena, Ajith K.
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Hornbuckle, Joanne
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Rees, Myrddin
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Rees, Charlotte
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Iveson, Tim
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Hickish, Tamas
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Maishman, Tom
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Stanton, Louise
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Dixon, Elizabeth
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Corkhill, Andrea
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Radford, Mike
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Garden, O. James
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Cunningham, David
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Maughan, Tim S.
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Bridgewater, John A.
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Primrose, John N.
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Pugh, Sian A.
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Bowers, Megan
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Ball, Alexandre
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Falk, Stephen
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Finch-Jones, Meg
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Valle, Juan W.
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O'Reilly, Derek A.
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Siriwardena, Ajith K.
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Hornbuckle, Joanne
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Rees, Myrddin
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Rees, Charlotte
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Iveson, Tim
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Hickish, Tamas
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Maishman, Tom
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Stanton, Louise
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Dixon, Elizabeth
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Corkhill, Andrea
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Radford, Mike
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Garden, O. James
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Cunningham, David
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Maughan, Tim S.
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Bridgewater, John A.
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Primrose, John N.
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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. and Primrose, John N. (2016) Patterns of progression, treatment of progressive disease and post-progression survival in the New EPOC study. British Journal of Cancer, 115, 420-424. (doi:10.1038/bjc.2016.208). (PMID:27434036)

Record type: Article

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.

Text
New EPOC Progression Manuscript second revision for BJC clean version.docx - Accepted Manuscript
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Accepted/In Press date: 13 June 2016
e-pub ahead of print date: 19 July 2016
Published date: 9 August 2016
Organisations: Cancer Sciences, Clinical Trials Unit

Identifiers

Local EPrints ID: 399580
URI: http://eprints.soton.ac.uk/id/eprint/399580
ISSN: 0007-0920
PURE UUID: 96fb14af-b9e8-4a76-b943-5490371f1905
ORCID for Tim Iveson: ORCID iD orcid.org/0000-0002-4681-2712
ORCID for Louise Stanton: ORCID iD orcid.org/0000-0001-8181-840X
ORCID for John N. Primrose: ORCID iD orcid.org/0000-0002-2069-7605

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Date deposited: 19 Aug 2016 13:18
Last modified: 15 Mar 2024 05:49

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Contributors

Author: Sian A. Pugh
Author: Megan Bowers
Author: Alexandre Ball
Author: Stephen Falk
Author: Meg Finch-Jones
Author: Juan W. Valle
Author: Derek A. O'Reilly
Author: Ajith K. Siriwardena
Author: Joanne Hornbuckle
Author: Myrddin Rees
Author: Charlotte Rees
Author: Tim Iveson ORCID iD
Author: Tamas Hickish
Author: Tom Maishman
Author: Louise Stanton ORCID iD
Author: Elizabeth Dixon
Author: Andrea Corkhill
Author: Mike Radford
Author: O. James Garden
Author: David Cunningham
Author: Tim S. Maughan
Author: John A. Bridgewater

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