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Metastatic colorectal cancer – Tumor location, left or right, impacts efficacy in KRAS/RAS wild-type patients

Background

Metastatic colorectal cancer, mCRC, is a group of distinct diseases, with clinical and molecular differences between right-sided and left-sided tumors driving varying prognosis.

Patients with KRAS/RAS-wild type (wt) mCRC treated in first line with Erbitux® or Vectibix® plus Oxaliplatin or Irinotecan-based chemotherapy were included in a retrospective study. The main objective was to analyze the prognostic effect of primary tumor location on efficacy parameters such as the percentage of patients who experienced either stop in tumor growth or shrinkage of it; the duration until the disease has progressed under the treatment and survival.

Results

52 Patients with KRAS-wt right-sided tumors had significantly lower efficacy as compared with 209 patients with KRAS-wt left-sided tumors.

25% of right-sided patients experienced either stop in tumor growth or shrinkage of it vs. 47% of left-sided patients.

Duration until the disease has progressed under the treatment was 7.2 months in right-sided patients vs. 9.9 months in left-sided patients; the risk of disease progression under the treatment was 40% lower in left-sided tumors.

Left-sided patients lived longer – Survival was 27.7 vs. 13.6 months; the risk of death during the treatment was lower by 50% in left-sided tumors.

Similar results were observed in the RAS-wt populations.

Conclusion

There are significantly improved efficacy outcomes in patients with KRAS/RAS-wt mCRC treated with first-line Erbitux® or Vectibix® plus Oxaliplatin or Irinotecan-based chemotherapy in left-sided primary tumors as compared with right-sided primary tumors.

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