Primary Tumour Response to Induction Chemotherapy in Synchronously Metastasized Colorectal Cancer

Study Overview
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Brief Summary
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We performed a retrospective data analysis of patients with synchronously metastasized colorectal cancer, comparing the histological response on the primary tumour to chemotherapy combined with either vascular endothelial growth factor (VEGF) or epidermal growth factor receptor (EGFR) inhibition.

Detailed Description
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We performed a retrospective analysis regarding the response of the primary tumour and the liver metastases of patients with colorectal carcinoma to an induction chemotherapy with antibody therapy, either with a VEGF antibody, or with an EGFR antibody. We investigated 100 Patients with synchronous metastatic colorectal carcinoma, who underwent hepatic resection in Clinic Landstraße or Clinic Favoriten between 2014 and 2021. We investigated the tumour response of the primary tumour, using Rödel score, which is a tumour regression score. We also investigated the tumour response of the liver metastases using Rubbia Brandt tumour regression score. The pathological response was assessed postoperatively in the surgical specimen. In order to ensure a uniform assessment, the pathologists in our HPB center assessed the histological specimens from both treatment locations prior to this analyses. The tumour response of the liver metastases was assessed twice: by radiological tumour assessment via computer tomography (CT) of the abdomen or magnetic resonance imaging (MRI) of the liver with RECIST criteria. Postoperative complications less than 90 days after liver resection were assessed and described according to the classification system by Dindo et al. Day of tumour recurrence and/or death was assessed. We also investigated the difference of recurrence free Survival (RFS) and Overall surcical (OS) between the patients, who received EGFR and the patients, who received VEGF antibody treatment.

Official Title
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Primary Tumour Response to Induction Chemotherapy in Synchronously Metastasized Colorectal Cancer

Conditions
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Gastrointestinal Neoplasm

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: older than 18 years synchronously hepatic metastasized patients with colorectal carcinoma indication of surgical treatment Exclusion Criteria: younger than 18 years metachronously metastasized patients

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients, who received a VEGF antibody<br>We distinguished between patients who received a VEGF antibody therapy and patients who received a EGFR antibody therapy. | |
| Patients, who received a EGFR antibody<br>We distinguished between patients who received a VEGF antibody therapy and patients who received a EGFR antibody therapy. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pathological response of the primary tumour | Investigation of the tumour response of the primary tumor (colorectal carcinoma) using the Rödel Score (tumour regression score) | Tumour regression was assessed in the surgical specimen 3 to 7 days after surgery. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pathological response of the liver metastases | Investigation of the tumour response of the liver metastases using Rubbia Brand score (Tumour regression score) and using radiological assessment | Tumour regression was assessed in the surgical specimen 3 to 7 days after surgery. Radiological response was assessed in staging CT abdomen 2 to 4 weeks after induction chemotherapy. | 
| Overall survival | Difference of overall survival between patients, who received VEGF antibody treatment and patients, who received EGFR antibody treatment | median of 21 months (0 to 80) | 
| Recurrece free survival | Difference of recurrence free survival between patients, who received VEGF antibody treatment and patients, who received EGFR antibody treatment | median of 21 months (0-80) | 
| 90 day mortality | number of patients, who died less than 90 days after liver surgery | 90 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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targeted therapy, colorectal cancer, synchronous liver metastases, tumour regression grading