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Retrospective analysis of pathological response in colorectal cancer liver metastases following treatment with bevacizumab

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Abstract

Aims

Pathological response has been shown to be a predictor for survival after preoperative chemotherapy and surgical resection of colorectal cancer liver metastases. This retrospective analysis evaluated the effect on pathological response of adding bevacizumab to standard neoadjuvant chemotherapy in patients with metastatic colorectal cancer (mCRC) and liver metastases.

Methods

Patient records from two Spanish centres were retrospectively examined for this analysis. Patients were included if they had stage IV mCRC with liver metastases, were unresectable or marginally resectable tumour before chemotherapy, and had oxaliplatin- or irinotecan-based chemotherapy, with or without bevacizumab, before resection. Tumour response was evaluated using response evaluation criteria in solid tumours (RECIST). Pathological response was assessed by pathologists blinded to treatment.

Results

Ninety-five patients were included. Good pathological responses (PR0/PR1) were observed in 37 patients (39 %). The RECIST response rate was 51 %. Only 42 % of patients with a good pathological response had a complete or partial response according to RECIST, while 57 % of those with a poor pathological response had a complete or partial response according to RECIST. RECIST response rates were similar with and without bevacizumab, although 49 % of bevacizumab-treated patients had a good pathological response versus 27 % of those receiving chemotherapy alone (χ 2 P = 0.0302).

Conclusion

Pathological response may be a better indicator of treatment efficacy than RECIST for patients with mCRC receiving bevacizumab in the neoadjuvant setting. Adding bevacizumab to chemotherapy has the potential to increase pathological response rates. Well-designed prospective clinical studies are required to establish the efficacy and tolerability of this approach.

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Acknowledgments

This study was supported by an unrestricted grant from Roche Farma S.A. The study sponsors had no involvement in the study design, collection, analysis and interpretation of data or in the decision to submit the manuscript for publication, but provided support for third-party writing assistance of this manuscript.

Conflict of interest

Santiago Lopez-Ben has received research funding from Roche. Rosa Maria Ortiz-Duran has received research funding from Roche. Esther Diaz has received research funding from Roche. Angels Quera has received research funding from Roche. Joan Figueras has a consultancy role for Roche, has received honoraria for speaking from Roche and Merck, and has received research funding from Roche. Ruth Vera, Marisa Gomez Dorronsoro, Antonio Viudez, Bernardo Queralt, Irene Hernandez, Cruz Zazpe, Jordi Soriano, Irene Amat, Javier Herrera Cabezón, Antoni Codina-Barreras and Xavi Hernandez-Yagüe have nothing to disclose.

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Authors and Affiliations

  1. Medical Oncology department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain

    R. Vera, A. Viudez & I. Hernandez

  2. Institut d’Investigació Biomèdica Girona, Hospital Josep Trueta, Gerona, Spain

    S. Lopez-Ben, B. Queralt, M. R. Ortiz-Duran, J. Soriano, E. Diaz, A. Codina-Barreras, X. Hernandez-Yagüe, A. Quera & J. Figueras

  3. Pathology department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain

    M. Gomez Dorronsoro & I. Amat

  4. Surgery department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain

    C. Zazpe & J. Herrera Cabezón

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  1. R. Vera
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  3. S. Lopez-Ben
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  9. J. Soriano
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  14. X. Hernandez-Yagüe
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Correspondence to R. Vera.

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Vera, R., Gomez Dorronsoro, M., Lopez-Ben, S. et al. Retrospective analysis of pathological response in colorectal cancer liver metastases following treatment with bevacizumab. Clin Transl Oncol 16, 739–745 (2014). https://doi.org/10.1007/s12094-013-1142-x

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  • DOI: https://doi.org/10.1007/s12094-013-1142-x

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