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Clinical impact of first-line bevacizumab plus chemotherapy in metastatic colorectal cancer of mucinous histology: a multicenter, retrospective analysis on 685 patients

  • Vincenzo CatalanoEmail author
  • Francesca Bergamo
  • Chiara Cremolini
  • Bruno Vincenzi
  • Francesca Negri
  • Paolo Giordani
  • Paolo Alessandroni
  • Rossana Intini
  • Silvia Stragliotto
  • Daniele Rossini
  • Beatrice Borelli
  • Daniele Santini
  • Donatella Sarti
  • Marco B. L. Rocchi
  • Sara Lonardi
  • Alfredo Falcone
  • Vittorina Zagonel
  • Rodolfo Mattioli
  • Francesco Graziano
Original Article – Clinical Oncology
  • 35 Downloads

Abstract

Purpose

In metastatic colorectal cancer (MCRC), mucinous histology has been associated with poor response rate and prognosis. We investigated whether bevacizumab combined with different chemotherapy regimens may have an impact on clinical outcomes of MCRC patients with mucinous histology.

Methods

685 MCRC patients were classified in mucinous adenocarcinoma (MC) and non-mucinous adenocarcinoma (NMC) and were treated with first-line bevacizumab plus fluoropyrimidine (FP)-based, oxaliplatin (OXA)-based, irinotecan (IRI)-based, or FOLFOXIRI.

Results

Ninety-four (13.7%) patients had MC. With a median follow-up of 50 months, MC patients had a median overall survival (OS) of 28.2 months compared with 27.7 months for the NMC group [hazard ratio (HR) = 0.92; 95% confidence interval (CI) 0.70–1.19, P = 0.530]. The overall response rates for MC and NMC were 41.5% (95% CI 31.5–51.4) and 62.4% (95% CI 58.4–66.3), respectively (Chi-square test, P <0.003). After correcting for significant prognostic factors by multivariate Cox regression analysis, age, resection of the primary tumour, and number of metastatic sites were found to be associated with poorer OS, but not mucinous histology.

Conclusion

Compared with NMC, MCRC patients with mucinous histology treated with bevacizumab plus chemotherapy had comparable OS despite lower overall response rate.

Keywords

Metastatic colorectal cancer Mucinous histology Chemotherapy Bevacizumab 

Notes

Author contributions

All named authors have participated in the study to a sufficient extent to be named as authors. The authors of the manuscript have seen and approved its final version. The article is original, it has not been previously published or has not been submitted for publication elsewhere while under consideration.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the provisions of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards and in accordance with international standards of Good Clinical Practice.

Informed consent

Informed consent was waived due to the retrospective nature of this study. Conduct of the investigation was approved by the review board of the Ethics Committee of the “Azienda Ospedaliera Ospedali Riuniti Marche Nord”, Pesaro, Italy.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Vincenzo Catalano
    • 1
    Email author
  • Francesca Bergamo
    • 2
  • Chiara Cremolini
    • 3
  • Bruno Vincenzi
    • 4
  • Francesca Negri
    • 5
  • Paolo Giordani
    • 1
  • Paolo Alessandroni
    • 1
  • Rossana Intini
    • 2
  • Silvia Stragliotto
    • 2
  • Daniele Rossini
    • 3
  • Beatrice Borelli
    • 3
  • Daniele Santini
    • 4
  • Donatella Sarti
    • 1
  • Marco B. L. Rocchi
    • 6
  • Sara Lonardi
    • 2
  • Alfredo Falcone
    • 3
  • Vittorina Zagonel
    • 2
  • Rodolfo Mattioli
    • 1
  • Francesco Graziano
    • 1
  1. 1.Department of OncologyAzienda Ospedaliera “Ospedali Riuniti Marche Nord”PesaroItaly
  2. 2.Medical Oncology Unit 1, Department of Clinical and Experimental OncologyIstituto Oncologico Veneto, IRCCSPaduaItaly
  3. 3.Unit of Medical Oncology, Department of Translational Research and New Technologies in Medicine, Azienda Ospedaliero-Universitaria PisanaUniversity of PisaPisaItaly
  4. 4.Department of Medical Oncology, Campus Bio-MedicoUniversità di RomaRomeItaly
  5. 5.Department of OncologyOspedale UniversitarioParmaItaly
  6. 6.Unità di Statistica Medica e Biometria, Department of Biomolecular SciencesUniversità “Carlo Bo”UrbinoItaly

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