Predictive factors of survival in patients with advanced colorectal cancer: an individual data analysis of 602 patients included in irinotecan phase III trials.
BACKGROUND
The infusional LV5FU2 and Arbeitsgemeinschaft Internische Onkologie (AIO) regimens are used widely in the treatment of advanced colorectal cancer. Irinotecan combined with these regimens increases survival in front-line treatment. Irinotecan also improves survival in second-line treatment.


METHODS
Univariate and multivariate analyses based on the individual data of 602 patients included in two phase III trials were performed to determine predictive factors of survival in advanced colorectal cancer.


RESULTS
Three factors were independently associated with a better progression-free survival: weight loss <5% [hazard ratio (HR) 1.25; 95% confidence interval (CI) 1.00-1.58], World Health Organization performance status (WHO PS) 0-1 (HR 1.29; 95% CI 1.08-1.54) and irinotecan (CPT-11)-containing regimens (HR 1.48; 95% CI 1.03-2.13). Five factors were independently associated with a better overall survival: weight loss <5% (HR 1.67; 95% CI 1.29-2.14), WHO PS 0-1 (HR 1.88; 95% CI 1.27-2.75), one or two metastatic sites (HR 1.24; 95% CI 1.01-1.53), alkaline phosphatase values not over twice the normal range (HR 1.71; 95% CI 1.30-2.24) and CPT-11-containing regimens (HR 1.31; 95% CI 1.07-1.61).


CONCLUSIONS
The present analysis confirms that CPT-11-based chemotherapy regimens are independently associated with a better survival in patients with advanced colorectal cancer. Age was not identified as a prognostic factor in this analysis.
Mitry
E
E
CHU Ambroise Pare, AP-HP, Boulogne-Billancourt. emmanuel.mitry@apr.ap-hop-paris.fr
Douillard
J-Y
JY
Van Cutsem
E
E
Cunningham
D
D
Magherini
E
E
Mery-Mignard
D
D
Awad
L
L
Rougier
P
P
D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D002166:Camptothecin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality; D004359:Drug Therapy, Combination; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
D000972:Antineoplastic Agents, Phytogenic; D000077146:Irinotecan; D005472:Fluorouracil; D002166:Camptothecin