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

doi:10.1038/bjc.2016.208

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 journal › Article › peer-review

Abstract / Description of output

Background
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.

Methods
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.

Results
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.

Conclusion
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 language	English
Journal	British Journal of Cancer
DOIs	https://doi.org/10.1038/bjc.2016.208
Publication status	Published - 19 Jul 2016

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James Garden
- Global Health Academy
- Edinburgh Imaging
- Deanery of Clinical Sciences - Professorial Fellow
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Pugh, S., Bowers , M., Ball, A., Falk , S., Finch-Jones , M., Valle , J., O’Reilly , D., Siriwardena , A., Hornbuckle , J., Rees , M., Rees , C., Iveson , T., Hickish , T., Maishman, T., Stanton , L., Dixon, E., Corkhill , A., Radford, M., Garden, O. J., ... Primrose , J. (2016). Patterns of progression, treatment of progressive disease and post-progression survival in the New EPOC Study. British Journal of Cancer. https://doi.org/10.1038/bjc.2016.208

@article{591d165d14754cabb33021d5b9b31636,

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

abstract = "BackgroundThe 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.MethodsA 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. ResultsThe 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. ConclusionBoth 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. ",

author = "Si{\^a}n Pugh and Megan Bowers and Alexandre Ball and Stephen Falk and Meg Finch-Jones and Juan Valle and Derek O{\textquoteright}Reilly and Ajith Siriwardena and Joanne Hornbuckle and Myrddin Rees and Charlotte Rees and Tim Iveson and Tamas Hickish and Tom Maishman and Louise Stanton and Elizabeth Dixon and Andrea Corkhill and Mike Radford and Garden, {O. James} and David Cunningham and Tim Maughan and John Bridgewater and John Primrose",

year = "2016",

month = jul,

day = "19",

doi = "10.1038/bjc.2016.208",

language = "English",

journal = "British Journal of Cancer",

issn = "0007-0920",

publisher = "Nature Publishing Group",

}

Pugh, S, Bowers , M, Ball, A, Falk , S, Finch-Jones , M, Valle , J, O’Reilly , D, Siriwardena , A, Hornbuckle , J, Rees , M, Rees , C, Iveson , T, Hickish , T, Maishman, T, Stanton , L, Dixon, E, Corkhill , A, Radford, M, Garden, OJ, Cunningham , D, Maughan , T, Bridgewater , J & Primrose , J 2016, 'Patterns of progression, treatment of progressive disease and post-progression survival in the New EPOC Study', British Journal of Cancer. https://doi.org/10.1038/bjc.2016.208

TY - JOUR

T1 - Patterns of progression, treatment of progressive disease and post-progression survival in the New EPOC Study

AU - Pugh, Siân

AU - Bowers , Megan

AU - Ball, Alexandre

AU - Falk , Stephen

AU - Finch-Jones , Meg

AU - Valle , Juan

AU - O’Reilly , Derek

AU - Siriwardena , Ajith

AU - Hornbuckle , Joanne

AU - Rees , Myrddin

AU - Rees , Charlotte

AU - Iveson , Tim

AU - Hickish , Tamas

AU - Maishman, Tom

AU - Stanton , Louise

AU - Dixon, Elizabeth

AU - Corkhill , Andrea

AU - Radford, Mike

AU - Garden, O. James

AU - Cunningham , David

AU - Maughan , Tim

AU - Bridgewater , John

AU - Primrose , John

PY - 2016/7/19

Y1 - 2016/7/19

N2 - BackgroundThe 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.MethodsA 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. ResultsThe 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. ConclusionBoth 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.

AB - BackgroundThe 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.MethodsA 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. ResultsThe 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. ConclusionBoth 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.

U2 - 10.1038/bjc.2016.208

DO - 10.1038/bjc.2016.208

M3 - Article

SN - 0007-0920

JO - British Journal of Cancer

JF - British Journal of Cancer

ER -

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

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