Clinical benefit of new targeted agents in phase I trials in patients with advanced colorectal cancer.
BACKGROUND
Standard treatment for patients with advanced colorectal cancer (ACRC) includes fluoropyrimidines in combination with oxaliplatin or irinotecan. The addition of targeted agents such as bevacizumab and cetuximab to these chemotherapy backbones further improved outcome with survival rates. However, even after intensive treatment, most tumors will subsequently progress and some patients are offered experimental phase I therapies.


METHODS
We retrospectively analyzed the outcome for 78 ACRC patients treated consecutively within 23 phase I trials at the Royal Marsden Hospital (RMH) between January 2004 and January 2008.


RESULTS
The median age was 62 years (range 26-78). After a median follow-up time of 21.4 weeks (range 1.7-115.6) the median progression-free survival and overall survival (OS) were 8.6 weeks (95% CI: 6.4-10.7) and 29.1 weeks (95% CI: 15.7-42.5), respectively. 28.8 and 8.2% of the patients were assessed as having stable disease (SD) at 3 and 6 months, respectively. Patients with SD had an OS of 40.6 weeks (95% CI: 32.9-48.2) compared to 17.4 weeks (95% CI: 14.0-20.8, p = 0.017) for patients with progressive disease.


CONCLUSIONS
A limited number of patients with ACRC who failed conventional treatments can derive clinical benefit by participating in phase I cancer trials, and the use of the RMH prognostic score can help to identify these patients.
Arkenau
Hendrik-Tobias
HT
Drug Development Unit, Royal Marsden Hospital, London and Surrey, UK. hendrik-tobias.arkenau@icr.ac.uk
Brunetto
Andre T
AT
Barriuso
Jorge
J
Olmos
David
D
Eaton
David
D
de Bono
Johann
J
Judson
Ian
I
Kaye
Stan
S
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017321:Clinical Trials, Phase I as Topic; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
D000970:Antineoplastic Agents