A role of targeted therapies combined with chemotherapy in the outcome of metastatic colorectal cancer in the clinical pratice

Abstract

Aims. To evaluate in the clinical practice the impact on relative survival of patients with metastatic colo-rectal carcinoma of the addiction of “targeted therapies”, combined with chemoterapy. Matherials and methods. A descriptive and retrospective study on 457 consecutive patients with metastatic colo-rectal carcinoma and accepted between Jan. 1st, 1994 and Mar. 31th, 2009 at the Clinical Oncology Unit of Azienda Ospedaliero – Universitaria of Ferrara. Results. 223 out of 457 enrolled patients (48.8%) received during the disease a fluoro-folate containig therapy, 172 (37.6%) also oxaliplatin and/or irinotecan, and 62 (13.6%) also “targeted therapies” (bevacizumab and/or cetuximab). Overall median survival was 8 months (C.I. 95%: 5-11 months). The comparison between patients having been submitted to “targeted therapies” or not showed a statistically significant difference (62.67 vs. 67.18 months; p<0.0001). In the subgroup of patients with age ≤ 70 years a statistically significative correlation has been shown as for number of chemotherapy lines (p<0.0001); kind of chemotherapy (p<0.0001), serum levels of CEA (p=0.006), CA19.9 (p=0.01), alkaline phosphatase (p=0.003), metastatic site (liver p=0.01, peritoneal p=0.05), performance status (p<0.001), presence of weigth loss (p=0.03) Conclusions. The above results confirm the literature data on the efficacy of the addiction of “targeted therapies” (bevacizumab and/or cetuximab) to the treatment scheme of advanced colo-rectal cancer, and the opportunity to employ in the sub-sequent lines all the active drugs (chemotherapy and monoclonal antibodies).