Predictive factors of severe early treatment-related toxicity in patients receiving first-line treatment for metastatic colorectal cancer: Pooled analysis of 2190 patients enrolled in Fédération Francophone de Cancérologie Digestive (FFCD) trials

Few studies have explored the association between baseline characteristics and the occurrence of early toxicities in patients treated with first-line chemotherapy for metastatic colorectal cancer (mCRC). Individual patient data of 2190 patients enrolled in 10 prospective FFCD (Fédération Francophone...

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Published in:European journal of cancer (1990) 2021-08, Vol.153, p.40-50
Main Authors: Breton, Clémence, Aparicio, Thomas, Le Malicot, Karine, Ducreux, Michel, Lecomte, Thierry, Bachet, Jean-Baptiste, Taieb, Julien, Legoux, Jean-Louis, De Gramont, Aimery, Bennouna, Jaafar, Bouché, Olivier, Boussari, Olayide, Manfredi, Sylvain, Gornet, Jean-Marc
Format: Article
Language:English
Subjects:
Abnormalities
Alkaline phosphatase
Baseline characteristics
Bevacizumab
Cancer
Chemotherapy
Clinical trials
Colorectal cancer
Colorectal carcinoma
Cytotoxicity
Irinotecan
Medical prognosis
Metastases
Metastasis
Multivariate analysis
Oxaliplatin
Patients
Prognostic factors
Toxicities
Toxicity
Tumors
Vascular endothelial growth factor
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Summary:Few studies have explored the association between baseline characteristics and the occurrence of early toxicities in patients treated with first-line chemotherapy for metastatic colorectal cancer (mCRC). Individual patient data of 2190 patients enrolled in 10 prospective FFCD (Fédération Francophone de Cancérologie Digestive) trials were analysed. Severe early toxicity was defined as the occurrence of grade ≥III toxicity within 3 months after initiation of chemotherapy (ET3). Patients received monotherapy based on 5-FU (n = 1068), a cytotoxic doublet (n = 395) or tritherapy with a cytotoxic doublet plus anti-VEGF agent or a cytotoxic triplet (n = 727). The patients received 5-FU (100%), Irinotecan (39.6%), Oxaliplatin (13.4%), Bevacizumab (29.6%) or Aflibercept (1.8%). ET3 occurred in 244 patients (22.8%) with monotherapy, 248 patients (62.8%) with doublet and 392 patients (53.9%) with tritherapy. The most frequent ET3s were related to biological abnormalities and/or gastrointestinal, general and vascular disorders. The prognostic factors for the occurrence of an ET3 in multivariate analysis were a performance status of 2 rather than 0–1 (OR 2.57; 95% CI [1.16, 5.73]; p = 0.02), tritherapy versus monotherapy (OR 2.31; 95% CI [0.84, 6.33]; p = 0.02), alkaline phosphatase > 300 UI/l (OR 3.07; 95% CI [1.79, 5.27]; p 
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2021.04.040