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J Cachexia Sarcopenia Muscle. 2015 Sep;6(3):231-6. doi: 10.1002/jcsm.12022. Epub 2015 May 5.

Anti-epidermal or anti-vascular endothelial growth factor as first-line metastatic colorectal cancer in modified Glasgow prognostic score 2' patients.

Author information

1
Gastroenterology and Endoscopy Unit, Hôpital Cochin, Université Paris Descartes, Sorbonne Paris Cité, Faculté de médecine, AP-HP Paris, France.
2
Medical Oncology, Department of Cancer Medicine, Gustave Roussy, Cancer Campus Grand Paris Villejuif, France.

Abstract

BACKGROUND:

In metastatic colorectal cancer, the modified Glasgow prognostic score (mGPS) has been approved as an independent prognostic indicator of survival. No data existed on poor prognosis patients treated with molecular-targeted agents.

METHODS:

From January 2007 to February 2012, patients with metastatic colorectal cancer and poor predictive survival score (mGPS = 2), treated with 5-fluorouracil-based chemotherapy in addition to an anti-epidermal growth factor receptor (EGFR) or anti-vascular epidermal growth factor (VEGF) therapy, were included to assess the interest of targeted therapy within mGPS = 2' patients.

RESULTS:

A total of 27 mGPS = 2' patients were included and received a 5-fluorouracil-based systemic chemotherapy in addition to an anti-EGFR treatment (cetuximab; n = 18) or an anti-VEGF treatment (bevacizumab; n = 9). Median follow-up was 12.1 months (interquartile range 4.9-22). Patients were Eastern Cooperative Oncology Group (ECOG) Performance Status 1, 2, and 3 in 66% (n = 18), 26% (n = 7), and 8% (n = 2), respectively. Comparing anti-EGFR and anti-VEGF groups, median progression-free survival was 3.9 and 15.4 months, respectively, and was significantly different (P = 0.046). Conversely, the median overall survival was not significantly different between the two groups (P = 0.15).

CONCLUSION:

Our study confirmed the poor survival of patients with mGPS = 2 despite the use of targeted therapy and identified the superiority of an anti-VEGF treatment in progression-free survival, without a significant benefit in the overall survival compared with the anti-EGFR therapy. Our results deserved confirmation by a prospective clinical trial.

KEYWORDS:

Bevacizumab; C-reactive protein; Cetuximab; Colorectal cancer; Epidermal growth factor receptor; Glasgow prognostic score; Targeted therapy; Vascular epithelial growth factor

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