Primary Site Colon Research Articles

Neutropenia as a Predictive Factor in Metastatic Colorectal Cancer Treated With TAS-102

BackgroundTAS-102 significantly improves overall survival in patients with metastatic colorectal cancer. The most common treatment-related adverse event of TAS-102 is bone marrow suppression, which leads to neutropenia. The potential predictive value of neutropenia caused by cytotoxic drugs has been reported in various types of cancer. MethodsWe retrospectively analyzed 95 consecutive patients with metastatic colorectal cancer who received TAS-102 at 2 Japanese institutions between May 2014 and May 2015. To evaluate the association between efficacy and neutropenia, patients were divided into 4 categories according to the grade of neutropenia during the first cycle of TAS-102: Category A (grade 0-1), B (grade 2-4), C (grade 0-2), and D (grade 3-4). ResultsPatient characteristics were as follows: median age, 64 years; male, 58%; Eastern Cooperative Oncology Group performance status 0 to 1, 91%; primary site colon, 49%; KRAS exon 2 wild, 57%; and number of metastatic site ≥ 3, 55%. The disease control rate was significantly different between Category A and B (29.2% vs. 52.6%; P = .045) and between Category C and D (30.9% vs. 72.2%; P = .002). In multivariate analysis, Category D remained a significant predictive factor for progression-free survival compared with Category C (4.3 vs. 2.0 months; hazard ratio, 0.45; P = .01). ConclusionNeutropenia caused by TAS-102 during the first cycle was associated with better efficacy. Neutropenia may be a surrogate marker for adequate antitumor doses of TAS-102.

Analysis of totally implantable venous access port systems (TIVAPS) related adverse events (AEs) in metastatic colorectal cancer (mCRC) patients treated with and without bevacizumab.

e14623 Background: TIVAPS are widely used for cancer chemotherapy. Bevacizumab, a key drug for mCRC, associates with AEs such as thromboembolism, bleeding, and impaired wound healing. Bevacizumab may complicit in increasing incidence of TIVAPS related AEs. To assess the incidence of TIVAPS related AEs in mCRC patients who received chemotherapy with and without bevacizumab. Methods: We retrospectively reviewed the medical records of consecutive patients whose TIVAPS were placed at our institution between Apr. 2004 and Apr. 2009. Major selection criteria were histologically proven colorectal adenocarcinoma, metastatic disease, and receiving chemotherapy after TIVAPS placement. We assessed the incidence of AEs occurred from the first administration of chemotherapy via TIVAPS to TIVAPS removal, death, or the last follow-up. We compared the incidence of TIVAPS related AEs in the cases bevacizumab was administered (group A) with that in the cases without bevacizumab administration (group B). Results: TIVAPS was placed 549 times for 505 patients, and 544 TIVAPS placements for 501 patients were analyzed. Bevacizumb was administered in 174 patients (32%), and median duration of bevacizumab therapy was 9.2 months. Characteristics of the cases in the group A and B were: male (60% and 59%); primary site colon (60% and 57%); catheterized in left subclavian vein (85% and 81%); history of prior chemotherapy (53% and 60%); median time from TIVAPS placement to administration of chemotherapy (1 day and 1 day). Incidence of common AEs in the group A and B were: infection (7.5% and 6.8%); venous thromboembolism (3.4% and 1.4%); TIVAPS occlusion (2.3% and 1.9%); delay of wound healing (1.1% and 0.5%); hematoma (0.6% vs 0%). Median time to AE in the group A and B was 21 months and 9 months. There was no significant difference in the incidence of TIVAPS related AEs between group A and B. During median observation period of 40.5 months, no arterial thrombotic event or AE resulted in death occurred. Conclusions: Addition of bevacizumab did not increase TIVAPS related AEs during chemotherapy for mCRC.