Catani Greta, Kim Stefano, Waisberg Federico, Enrico Diego, Luca Romina, Esteso Federico, Bruno Luisina, Rodríguez Andrés, Bortz Marcos, Freile Berenice, Chacón Matías, Oviedo Albor Ana Isabel, Méndez Guillermo, Slutsky Ezequiel, Baiud María Cristina, Llanos Romina, Solonyezny Ayelen, Basbus Luis, Arroyo Gerardo, Grasselli Julieta, Pasquinelli Rosario, Bella Quero Luciana, Faura María Victoria, Adur Ana Cecilia, Dioca Mariano, Tamburelli Mercedes, Castillo Javier, O'Connor Juan Manuel
Department of Oncology, Alexander Fleming Institute, Buenos Aires 1426, Argentina.
Equipo Multidisciplinario de Oncología Gastrointestinal (EMOGI), Asociación Argentina de Oncología Clínica, Federico Lacroze 2252, Argentina.
Cancers (Basel). 2025 Mar 17;17(6):1007. doi: 10.3390/cancers17061007.
BACKGROUND/OBJECTIVES: The -mutation is a poor prognostic factor in colorectal cancer (CRC). There is a need for real-world data in low-middle-income countries regarding clinical characteristics, outcomes, and treatment strategies. This study aims to describe progression-free survival (PFS) and in the first- and second-line setting and sequences of treatment regimens.
We retrospectively analyze patients from ten oncology centers in Argentina, diagnosed with -mutated advanced CRC between January 2014 and July 2023.
A total of 161 patients with metastatic CRC and -mutation. The median age was 58.5 (IQR 47-69), and 21.7% were MMR-deficient (dMMR). Of these patients, 93.8% received first-line treatment. With a median follow-up of 23 months (95% CI 16.5-33.4 months), the median PFS was 9 months (95% CI 7.4-10.5 months). The most common regimen in first line setting was doublet chemotherapy plus anti-VEGF for 49% of the patients. Twenty-six percent of the patients received BRAF inhibitors in the second-line setting, with a median PFS of 5.2 months (95% CI 4.9-NR); the overall response rate (ORR) was 10.5%.
This study represents, to the best of our knowledge, the largest published real-world cohort of -mutated CRC in Latin America. The heterogeneity of the treatments reflects the existence of barriers to access to high-cost drugs in our country. Cooperative efforts are needed to understand the particular characteristics of this subgroup of patients.
背景/目的:-突变是结直肠癌(CRC)的不良预后因素。中低收入国家需要有关临床特征、结局和治疗策略的真实世界数据。本研究旨在描述一线和二线治疗环境下的无进展生存期(PFS)以及治疗方案的顺序。
我们回顾性分析了2014年1月至2023年7月期间在阿根廷十个肿瘤中心诊断为-突变晚期CRC的患者。
共有161例转移性CRC和-突变患者。中位年龄为58.5岁(四分位间距47 - 69岁),21.7%为错配修复缺陷(dMMR)。这些患者中,93.8%接受了一线治疗。中位随访23个月(95%可信区间16.5 - 33.4个月),中位PFS为9个月(95%可信区间7.4 - 10.5个月)。一线治疗中最常见的方案是双联化疗加抗VEGF,49%的患者采用该方案。26%的患者在二线治疗中接受了BRAF抑制剂,中位PFS为5.2个月(95%可信区间4.9 - 未达到);总缓解率(ORR)为10.5%。
据我们所知,本研究是拉丁美洲发表的最大规模的-突变CRC真实世界队列。治疗的异质性反映了我国在获取高成本药物方面存在障碍。需要合作努力来了解这一亚组患者的特殊特征。