Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy; Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy.
Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Clin Colorectal Cancer. 2019 Jun;18(2):116-124. doi: 10.1016/j.clcc.2019.02.007. Epub 2019 Mar 7.
Adenocarcinoma with mucinous histology or mucinous component are histologic subtypes of metastatic colorectal cancers (mCRCs) with limited benefit from cytotoxic agents. Their sensitivity to anti-epithelial growth factor receptors (EGFRs) is not clear.
The activity and efficacy of anti-EGFRs was retrospectively evaluated among patients with RAS and BRAF wild-type mCRC with or without mucinous histology or mucinous component. Subgroup analyses according to primary tumor location were conducted.
Overall, the study population included 22 mucinous or with mucinous component tumors (11 right- and 11 left-sided tumors) and 83 not mucinous tumors. One patient experienced partial response among mucinous tumors, whereas in the not mucinous group, 42 patients experienced partial response, with an overall response rate of 4% and 51%, respectively (P = .003). The median progression-free survival was 2.8 versus 6.7 months (hazard ratio, 0.28; 95% confidence interval, 0.13-0.59; P < .001), and the median overall survival was 6.5 and 16.7 months (hazard ratio, 0.58; 95% confidence interval, 0.33-1.00; P = .022), for the mucinous and not mucinous groups, respectively. Similar results were observed in subgroup analysis according to primary tumor location.
Anti-EGFRs may not provide clinically meaningful benefit in mCRCs with mucinous histology or mucinous component compared with those without mucinous component, irrespective of sidedness.
具有黏液组织学或黏液成分的腺癌是转移性结直肠癌（mCRC）的组织学亚型，细胞毒性药物对其疗效有限。它们对抗表皮生长因子受体（EGFRs）的敏感性尚不清楚。
本研究回顾性评估了 RAS 和 BRAF 野生型 mCRC 患者中，有无黏液组织学或黏液成分，以及原发肿瘤位置，对其接受抗 EGFR 治疗的疗效。
研究人群中包括 22 例黏液性或伴黏液成分的肿瘤（11 例右半结肠肿瘤和 11 例左半结肠肿瘤）和 83 例非黏液性肿瘤。黏液性肿瘤中 1 例患者部分缓解，而非黏液性组中 42 例患者部分缓解，总缓解率分别为 4%和 51%（P=0.003）。无进展生存期分别为 2.8 个月和 6.7 个月（风险比，0.28；95%置信区间，0.13-0.59；P<0.001），总生存期分别为 6.5 个月和 16.7 个月（风险比，0.58；95%置信区间，0.33-1.00；P=0.022），黏液性和非黏液性组分别如此。按原发肿瘤位置进行亚组分析，也观察到了相似的结果。
与无黏液成分的 mCRC 相比，抗 EGFRs 可能并不能为具有黏液组织学或黏液成分的 mCRC 患者提供有临床意义的获益，无论肿瘤位置如何。
