Preview

Surgery and Oncology

Advanced search

Effect of cancer drugs in patients with metastatic colorectal cancer in terms of mortality reduction

https://doi.org/10.17650/2220-3478-2017-7-3-11-15

Abstract

Background. Colorectal cancer (CRC) is the 4th most frequent cause of death among patients with malignant tumors worldwide. In 2012, approximately 1.3 million people were diagnosed with CRC, nearly 690 000 patients died.
Objective: to assess the impact of various chemotherapeutic drugs and monoclonal antibodies penetration on the dynamics of CRC-associated mortality in patients with metastatic CRC in Russia.
Materials and methods. We analyzed the mortality data for 2014 obtained from the National Cancer Register and the data from the Register of Chemotherapy Drugs (oxaliplatin, irinotecan, capecitabine) and Monoclonal Antibodies (bevacizumab, cetuximab, panitumumab) Procurement for cancer centers from 82 regions of Russia. We performed correlation and regression analysis to estimate the impact of various chemotherapeutic drugs and monoclonal antibodies penetration on the CRC-associated mortality, as well as the mortality from colon cancer and rectal cancer.
Results. We observed a correlation between the mortality reduction in patients with metastatic CRC and penetration of irinotecan (k = –0.324, р = 0.003), capecitabine (k = –0.223, p = 0.04), bevacizumab (k = –0.229, p = 0.04), panitumumab (k = –0.232, p = 0.04), any anti-EGFR monoclonal antibody (k = –0.201, p = 0.07) and all monoclonal antibodies (k = –0.256, p = 0.02). Regression analysis demonstrated a decreased mortality rates in patients receiving irinotecan (β = –0.26, р = 0.02), anti-EGFR monoclonal antibodies (β = –0.19, р = 0.09) and oxaliplatin or irinotecan (β = –0.2, р = 0.06).
Conclusion. Our results suggest a correlation between the administration of irinotecan and monoclonal antibodies and mortality reduction in patients with metastatic CRC.

About the Authors

M. Yu. Fedyanin
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
23 Kashirskoe Shosse, Moscow 115478, Russia


I. A. Pokataev
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
23 Kashirskoe Shosse, Moscow 115478, Russia


O. V. Sekhina
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
23 Kashirskoe Shosse, Moscow 115478, Russia


A. A. Tryakin
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
23 Kashirskoe Shosse, Moscow 115478, Russia


S. A. Tjulandin
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
23 Kashirskoe Shosse, Moscow 115478, Russia


References

1. GLOBOSCAN 2012: estimated cancer incidence, mortality and 5-year prevalence worldwide in 2012. Available at: http://globocan.iarc.fr/Pages/fact_sheets_population.aspx.

2. Hurwitz H., Fehrenbacher L., Novotny W. et al. Bevacizumab plus irinotecan, fluorouracil and leucovorin for metastatic colorectal cancer. N Engl J Med 2004;350(23):2335–42. DOI: 10.1056/NEJMoa032691.

3. Saltz L.B., Clarke S., Diaz-Rubio E. et al. Bevacizumab in combination with XELOX or FOLFOX4: efficacy results from XELOX-1/NO16966, a randomized phase III trial in the 1st line of treatment of metastatic colorectal cancer. ASCO 2007 Gastrointestinal Cancers Symposium, 2007. Abstr. 238.

4. Giantonio B.J., Catalano P.J., Meropol N.J. et al. Bevacizumab in combination with oxaliplatin, fluorouracil and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: results from the Eastern Cooperative Oncology Group Study E3200. J Clin Oncol 2007;25(12):1539–44. DOI: 10.1200/JCO.2006.09.6305.

5. Van Cutsem E., Lenz H.J., Kohne C.H. et al. Fluorouracil, leucovorin and irinotecan plus cetuximab treatment and RAS mutations in colorectal cancer. J Clin Oncol 2015;33(7):692–700. DOI: 10.1200/JCO.2014.59.4812.

6. Douillard J.Y., Siena S., Tabernero J. et al. Overall survival and tumor shrinkage outcomes in patients with symptomatic/asymptomatic metastatic colorectal cancer: data from the PRIME study. Ann Oncol 2013;24(4):iv25–50. DOI: 10.1093/annonc/mdt202.23.

7. Злокачественные новообразования в России в 2014 г. (заболеваемость и смертность). Под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИРЦ» Минздрава России, 2016. 250 с. [Malignant tumors in Russia in 2014 (incidence and mortality). Eds.: A.D. Kaprin, V.V. Starinskiy, G.V. Petrova. Moscow: MNIOI im. P.A. Gertsena – filial FGBU “NMIRTS” Minzdrava Rossii, 2016. 250 p. (In Russ.)].

8. Состояние онкологической помощи населению России в 2015 г. Под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИРЦ» Минздрава России, 2016. 236 с. [Situation with cancer care in Russia in 2015. Eds.: A.D. Kaprin, V.V. Starinskiy, G.V. Petrova. Moscow: MNIOI im. P.A. Gertsena – filial FGBU “NMIRTS” Minzdrava Rossii, 2016. 236 p. (In Russ.)].

9. Narod S.A., Iqbal J., Miller A.B. et al. Why have breast cancer mortality rates declined? J Cancer Policy 2015;6(5):8–17. DOI: 10.1016/j.jcpo.2015.03.002.

10. Grothey A., Sargent D., Goldberg R.M. et al. Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil–leucovorin, irinotecan and oxaliplatin in the course of treatment. J Clin Oncol 2004;22(7):1209–14. DOI: 10.1200/JCO.2004.11.037.

11. Fedyanin M., Aliyeva S., Vladimirova L.Y. et al. Evaluation of the quality of cancer treatment in a population of patients with metastatic colorectal cancer in routine clinical practice in different regions of Russia. J Clin Oncol 2017;(35 Suppl 15):e18022. DOI: 10.1200/JCO.2017.35.15_suppl.e18022.


Review

Views: 550


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2949-5857 (Online)