Body Mass Index Is Prognostic in Metastatic Colorectal Cancer: Pooled Analysis of Patients From First-Line Clinical Trials in the ARCAD Database.
OBJECTIVE
In recent retrospective analyses of early-stage colorectal cancer (CRC), low and high body mass index (BMI) scores were associated with worsened outcomes. Whether BMI is a prognostic or predictive factor in metastatic CRC (mCRC) is unclear.


METHODS
Individual data from 21,149 patients enrolled onto 25 first-line mCRC trials during 1997 to 2012 were pooled. We assessed both prognostic and predictive effects of BMI on overall survival and progression-free survival, and we accounted for patient and tumor characteristics and therapy type (targeted v nontargeted).


RESULTS
BMI was prognostic for overall survival (P < .001) and progression-free survival (P < .001), with an L-shaped pattern. That is, risk of progression and/or death was greatest for low BMI; risk decreased as BMI increased to approximately 28 kg/m(2), and then it plateaued. Relative to obese patients, patients with a BMI of 18.5 kg/m(2) had a 27% increased risk of having a PFS event (95% CI, 20% to 34%) and a 50% increased risk of death (95% CI, 43% to 56%). Low BMI was associated with poorer survival for men than women (interaction P < .001). BMI was not predictive of treatment effect.


CONCLUSIONS
Low BMI is associated with an increased risk of progression and death among the patients enrolled on the mCRC trials, with no increased risk for elevated BMI, in contrast to the adjuvant setting. Possible explanations include negative effects related to cancer cachexia in patients with low BMI, increased drug delivery or selection bias in patients with high BMI, and potential for an interaction between BMI and molecular signaling pathways.
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY. renfro.lindsay@mayo.edu.
Lindsay A
LA
Renfro
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Fotios
F
Loupakis
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Richard A
RA
Adams
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Matthew T
MT
Seymour
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Volker
V
Heinemann
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Hans-Joachim
HJ
Schmoll
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Jean-Yves
JY
Douillard
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Herbert
H
Hurwitz
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Charles S
CS
Fuchs
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Eduardo
E
Diaz-Rubio
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Rainer
R
Porschen
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Christophe
C
Tournigand
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Benoist
B
Chibaudel
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Alfredo
A
Falcone
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Niall C
NC
Tebbutt
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Cornelis J A
CJ
Punt
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
J Randolph
JR
Hecht
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Carsten
C
Bokemeyer
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Eric
E
Van Cutsem
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Richard M
RM
Goldberg
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Leonard B
LB
Saltz
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Aimery
A
de Gramont
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Daniel J
DJ
Sargent
Lindsay A. Renfro and Daniel J. Sargent, Mayo Clinic, Rochester, MN; Fotios Loupakis and Alfredo Falcone, Azienda Ospedaliero-Universitaria Pisana and Università di Pisa, Pisa, Italy; Richard Adams, Cardiff University, Cardiff; Matthew T. Seymour, St James's Hospital and University of Leeds, Leeds, United Kingdom; Volker Heinemann, University of Munich, Munich; Hans-Joachim Schmoll, University Clinic Halle (Saale), Halle; Rainer Porschen, Klinikum Bremen-Ost Klinik für Innere Medizin, Bremen; Carsten Bokemeyer, University Hospital Cancer Center, University Hospital, Hamburg-Eppendorf, Germany; Jean-Yves Douillard, Institut de Cancerologie, Centre René Gauducheau, Nantes; Christophe Tournigand, University of Paris Est Creteil, Henri-Mondor Hospital, Créteil; Benoist Chibaudel and Aimery de Gramont, Franco-British Institute, Levallois-Perret, France; Herbert Hurwitz, Duke University Medical Center, Durham, NC; Charles S. Fuchs, Dana-Farber Cancer Institute Boston, MA; Eduardo Diaz-Rubio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain; Niall C. Tebbutt, Austin Health, Heidelberg, Victoria, Australia; Cornelis J.A. Punt, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; J. Randolph Hecht, David Geffen School of Medicine at the University of California at Los Angeles; Heinz-Josef Lenz, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA; Eric Van Cutsem, University Hospital Leuven, Leuven, Belgium; Richard M. Goldberg, Ohio State University, Columbus, OH; and Leonard B. Saltz, Memorial Sloan-Kettering Cancer Center, New York, NY.
Heinz-Josef
HJ
Lenz
D000970:Antineoplastic Agents / Q000008:administration & dosage; D015992:Body Mass Index; D002100:Cachexia / Q000209:etiology* / Q000378:metabolism / Q000401:mortality; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000150:complications / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009765:Obesity / Q000378:metabolism; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D015983:Selection Bias; D015398:Signal Transduction
D000970:Antineoplastic Agents