title: Pathological responses after angiogenesis or EGFR inhibitors in metastatic colorectal cancer depend on the chemotherapy backbone.
abstract: BACKGROUND
  Optimal preoperative treatment before colorectal cancer metastases (CRCM) resection remains unclear. This study evaluated pathological responses (pR) in CRCM resected after chemotherapy alone or combined with angiogenesis or epidermal growth factor receptor (EGFR) inhibitors.
  
  
  METHODS
  Pathological response was retrospectively evaluated on 264 resected metastases from 99 patients. The proportion of responding metastases after different preoperative treatments was reported and compared. Patient's progression-free survival (PFS) and overall survival (OS) were compared based on pR.
  
  
  RESULTS
  The combination of anti-angiogenics with oxaliplatin-based chemotherapy resulted in more pR than when they were combined with irinotecan-based chemotherapy (80% vs 50%; P<0.001). Inversely, the combination of EGFR inhibitors with oxaliplatin-based chemotherapy seemed to induce fewer pR than when they were combined with irinotecan-based treatment (53% vs 72%; P=0.049). Overall survival at 5 years was improved for patients with a pR in all resected metastases compared with those who did not achieve a pR (68.5% vs 32.6%; P=0.023) and this response was the only factor predicting OS in a multivariate analysis.
  
  
  CONCLUSIONS
  The chemotherapy partner combined with angiogenesis or EGFR inhibitors influenced pR in resected CRCM. In our exploratory analysis anti-angiogenic/oxaliplatin-based regimens and anti-EGFR/irinotecan-based regimens were associated with the highest pR. Prospective randomised trials should be performed to validate these observations.
authors.affiliation: Department of Medical Oncology, Grand Hôpital de Charleroi (GHdC), Grand rue 3, 6000 Charleroi, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Carrasco
authors.affiliation: Department of Medical Oncology, Grand Hôpital de Charleroi (GHdC), Grand rue 3, 6000 Charleroi, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Gizzi
authors.affiliation: Department of Pathology, Cliniques Universitaires St-Luc/Université Catholique de Louvain (UCL), Avenue Hippocrate 10, 1200 Brussels, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Pairet
authors.affiliation: Department of Medical Oncology, Cliniques Universitaires St-Luc/Université Catholique de Louvain (UCL), Avenue Hippocrate 10, 1200 Brussels, Belgium.
authors.forename: V
authors.initials: V
authors.lastname: Lannoy
authors.affiliation: Department of Molecular Pathology, Institut de Pathologie et de Génétique (IPG), Avenue Georges Lemaître 25, 6041 Gosselies, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Lefesvre
authors.affiliation: Department of Abdominal Surgery and Transplantation, Cliniques Universitaires St-Luc/Université Catholique de Louvain (UCL), Avenue Hippocrate 10, 1200 Brussels, Belgium.
authors.forename: J-F
authors.initials: JF
authors.lastname: Gigot
authors.affiliation: Department of Abdominal Surgery and Transplantation, Cliniques Universitaires St-Luc/Université Catholique de Louvain (UCL), Avenue Hippocrate 10, 1200 Brussels, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Hubert
authors.affiliation: Department of Pathology, Cliniques Universitaires St-Luc/Université Catholique de Louvain (UCL), Avenue Hippocrate 10, 1200 Brussels, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Jouret-Mourin
authors.affiliation: Department of Medical Oncology, Cliniques Universitaires St-Luc/Université Catholique de Louvain (UCL), Avenue Hippocrate 10, 1200 Brussels, Belgium.
authors.forename: Y
authors.initials: Y
authors.lastname: Humblet
authors.affiliation: Department of Medical Oncology, Grand Hôpital de Charleroi (GHdC), Grand rue 3, 6000 Charleroi, Belgium.
authors.forename: J-L
authors.initials: JL
authors.lastname: Canon
authors.affiliation: Department of Pathology, Cliniques Universitaires St-Luc/Université Catholique de Louvain (UCL), Avenue Hippocrate 10, 1200 Brussels, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Sempoux
authors.affiliation: Department of Radiolgy, Grand Hôpital de Charleroi (GHdC), Grand rue 3, 6000 Charleroi, Belgium.
authors.forename: X
authors.initials: X
authors.lastname: Chapaux
authors.affiliation: Department of Radiology, Cliniques Universitaires St-Luc/Université Catholique de Louvain (UCL), Avenue Hippocrate 10, 1200 Brussels, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Danse
authors.affiliation: Department of Abdominal Surgery, Grand Hôpital de Charleroi (GHdC), Grand rue 3, 6000 Charleroi, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Tinton
authors.affiliation: Department of Abdominal Surgery and Transplantation, Cliniques Universitaires St-Luc/Université Catholique de Louvain (UCL), Avenue Hippocrate 10, 1200 Brussels, Belgium.
authors.forename: B
authors.initials: B
authors.lastname: Navez
authors.affiliation: Department of Medical Oncology, Cliniques Universitaires St-Luc/Université Catholique de Louvain (UCL), Avenue Hippocrate 10, 1200 Brussels, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Van den Eynde
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002166:Camptothecin / Q000031:analogs & derivatives / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology*; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000819:agonists*; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D000077150:Oxaliplatin; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000077146:Irinotecan; C512478:EGFR protein, human; D066246:ErbB Receptors; D002166:Camptothecin