Clinical impact of first-line bevacizumab plus chemotherapy in metastatic colorectal cancer of mucinous histology: a multicenter, retrospective analysis on 685 patients
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In metastatic colorectal cancer (MCRC), mucinous histology has been associated with poor response rate and prognosis. We investigated whether bevacizumab combined with different chemotherapy regimens may have an impact on clinical outcomes of MCRC patients with mucinous histology.
685 MCRC patients were classified in mucinous adenocarcinoma (MC) and non-mucinous adenocarcinoma (NMC) and were treated with first-line bevacizumab plus fluoropyrimidine (FP)-based, oxaliplatin (OXA)-based, irinotecan (IRI)-based, or FOLFOXIRI.
Ninety-four (13.7%) patients had MC. With a median follow-up of 50 months, MC patients had a median overall survival (OS) of 28.2 months compared with 27.7 months for the NMC group [hazard ratio (HR) = 0.92; 95% confidence interval (CI) 0.70–1.19, P = 0.530]. The overall response rates for MC and NMC were 41.5% (95% CI 31.5–51.4) and 62.4% (95% CI 58.4–66.3), respectively (Chi-square test, P <0.003). After correcting for significant prognostic factors by multivariate Cox regression analysis, age, resection of the primary tumour, and number of metastatic sites were found to be associated with poorer OS, but not mucinous histology.
Compared with NMC, MCRC patients with mucinous histology treated with bevacizumab plus chemotherapy had comparable OS despite lower overall response rate.
KeywordsMetastatic colorectal cancer Mucinous histology Chemotherapy Bevacizumab
All named authors have participated in the study to a sufficient extent to be named as authors. The authors of the manuscript have seen and approved its final version. The article is original, it has not been previously published or has not been submitted for publication elsewhere while under consideration.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the provisions of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards and in accordance with international standards of Good Clinical Practice.
Informed consent was waived due to the retrospective nature of this study. Conduct of the investigation was approved by the review board of the Ethics Committee of the “Azienda Ospedaliera Ospedali Riuniti Marche Nord”, Pesaro, Italy.
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