Patterns of progression, treatment of progressive disease and post-progression survival in the New EPOC Study

Siân Pugh, Megan Bowers , Alexandre Ball, Stephen Falk , Meg Finch-Jones , Juan Valle , Derek O’Reilly , Ajith Siriwardena , Joanne Hornbuckle , Myrddin Rees , Charlotte Rees , Tim Iveson , Tamas Hickish , Tom Maishman, Louise Stanton , Elizabeth Dixon, Andrea Corkhill , Mike Radford, O. James Garden, David Cunningham Tim Maughan , John Bridgewater , John Primrose

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

The addition of cetuximab to perioperative chemotherapy for operable colorectal liver metastases resulted in a shorter progression free survival. Details of disease progression are described to further inform the primary study outcome.

A total of 257 KRAS wild-type patients were randomised to chemotherapy alone or chemotherapy with cetuximab. Data regarding sites and treatment of progressive disease were obtained for the 109 (chemotherapy n=48, chemotherapy and cetuximab n=61) patients with progressive disease at the cut-off date for analysis of November 2012.

The liver was the most frequent site of progression (chemotherapy 67% (32/48); chemotherapy and cetuximab 66% (40/61)). A higher proportion of patients in the cetuximab group had multi-site/other sites of progressive disease (chemotherapy 8%, 4/48; chemotherapy and cetuximab 23%, 14/61 p=0.04). Further treatment for progressive disease is known for 84 patients of whom 69 received further chemotherapy, most frequently irinotecan based. Twenty two patients, 11 in each arm, received cetuximab as a further line agent.

Both the distribution of progressive disease and further treatment are as expected for such a cohort. The pattern of disease progression seen is consistent with failure of systemic micrometastatic disease control rather than failure of local disease control following liver surgery.
Original languageEnglish
JournalBritish Journal of Cancer
Publication statusPublished - 19 Jul 2016


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