TY - JOUR
T1 - Survival improvement for patients with metastatic colorectal cancer over twenty years
AU - Zeineddine, Fadl A.
AU - Zeineddine, Mohammad A.
AU - Yousef, Abdelrahman
AU - Gu, Yue
AU - Chowdhury, Saikat
AU - Dasari, Arvind
AU - Huey, Ryan W.
AU - Johnson, Benny
AU - Kee, Bryan
AU - Lee, Michael S.
AU - Morelli, Maria Pia
AU - Morris, Van K.
AU - Overman, Michael J.
AU - Parseghian, Christine
AU - Raghav, Kanwal
AU - Willis, Jason
AU - Wolff, Robert A.
AU - Kawaguchi, Yoshikuni
AU - Vauthey, Jean Nicolas
AU - Sun, Ryan
AU - Kopetz, Scott
AU - Shen, John Paul
N1 - Funding Information:
Patient population and various related data elements were identified and retrieved through a search of the Tumor Registry database maintained by the Department of Tumor Registry. We also thank Drew Goldstein, Anastasia Turin, and Lori Kohen for assistance with developing the Foundry software used for data aggregation. This work was supported by the National Cancer Institute (L30 CA171000 and K22 CA234406 to J.P.S., SPORE P50CA221707 to S.K, and The Cancer Center Support Grant P30 CA016672), the Cancer Prevention & Research Institute of Texas (RR180035 to J.P.S., J.P.S. is a CPRIT Scholar in Cancer Research), the MD Anderson Colorectal Cancer Moonshot Program and the Col. Daniel Connelly Memorial Fund. This work was also funded by a Conquer Cancer Career Development Award to J.P.S. Any opinions, findings, and conclusions expressed in this material are those of the author(s) and do not necessarily reflect those of the American Society of Clinical Oncology® or Conquer Cancer.
Funding Information:
Patient population and various related data elements were identified and retrieved through a search of the Tumor Registry database maintained by the Department of Tumor Registry. We also thank Drew Goldstein, Anastasia Turin, and Lori Kohen for assistance with developing the Foundry software used for data aggregation. This work was supported by the National Cancer Institute (L30 CA171000 and K22 CA234406 to J.P.S., SPORE P50CA221707 to S.K, and The Cancer Center Support Grant P30 CA016672), the Cancer Prevention & Research Institute of Texas (RR180035 to J.P.S., J.P.S. is a CPRIT Scholar in Cancer Research), the MD Anderson Colorectal Cancer Moonshot Program and the Col. Daniel Connelly Memorial Fund. This work was also funded by a Conquer Cancer Career Development Award to J.P.S. Any opinions, findings, and conclusions expressed in this material are those of the author(s) and do not necessarily reflect those of the American Society of Clinical Oncology® or Conquer Cancer.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - Over the past two decades of successive clinical trials in metastatic colorectal cancer (CRC), the median overall survival of both control and experimental arms has steadily improved. However, the incremental change in survival for metastatic CRC patients not treated on trial has not yet been quantified. We performed a retrospective review of 1420 patients with de novo metastatic CRC who received their primary treatment at the University of Texas M.D. Anderson Cancer Center (UTMDACC) from 2004 through 2019. Median OS was roughly stable for patients diagnosed between 2004 and 2012 (22.6 months) but since has steadily improved for those diagnosed in 2013 to 2015 (28.8 months), and 2016 to 2019 (32.4 months). Likewise, 5-year survival rate has increased from 15.7% for patients diagnosed from 2004 to 2006 to 26% for those diagnosed from 2013 to 2015. Notably, survival improved for patients with BRAFV600E mutant as well as microsatellite unstable (MSI-H) tumors. Multivariate regression analysis identified surgical resection of liver metastasis (HR = 0.26, 95% CI, 0.19–0.37), use of immunotherapy (HR = 0.44, 95% CI, 0.29–0.67) and use of third line chemotherapy (regorafenib or trifluridine/tipiracil, HR = 0.74, 95% CI, 0.58–0.95), but not year of diagnosis (HR = 0.99, 95% CI, 0.98–1), as associated with better survival, suggesting that increased use of these therapies are the drivers of the observed improvement in survival.
AB - Over the past two decades of successive clinical trials in metastatic colorectal cancer (CRC), the median overall survival of both control and experimental arms has steadily improved. However, the incremental change in survival for metastatic CRC patients not treated on trial has not yet been quantified. We performed a retrospective review of 1420 patients with de novo metastatic CRC who received their primary treatment at the University of Texas M.D. Anderson Cancer Center (UTMDACC) from 2004 through 2019. Median OS was roughly stable for patients diagnosed between 2004 and 2012 (22.6 months) but since has steadily improved for those diagnosed in 2013 to 2015 (28.8 months), and 2016 to 2019 (32.4 months). Likewise, 5-year survival rate has increased from 15.7% for patients diagnosed from 2004 to 2006 to 26% for those diagnosed from 2013 to 2015. Notably, survival improved for patients with BRAFV600E mutant as well as microsatellite unstable (MSI-H) tumors. Multivariate regression analysis identified surgical resection of liver metastasis (HR = 0.26, 95% CI, 0.19–0.37), use of immunotherapy (HR = 0.44, 95% CI, 0.29–0.67) and use of third line chemotherapy (regorafenib or trifluridine/tipiracil, HR = 0.74, 95% CI, 0.58–0.95), but not year of diagnosis (HR = 0.99, 95% CI, 0.98–1), as associated with better survival, suggesting that increased use of these therapies are the drivers of the observed improvement in survival.
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U2 - 10.1038/s41698-023-00353-4
DO - 10.1038/s41698-023-00353-4
M3 - Article
C2 - 36781990
AN - SCOPUS:85148293517
SN - 2397-768X
VL - 7
JO - npj Precision Oncology
JF - npj Precision Oncology
IS - 1
M1 - 16
ER -