Ruolo delle “targeted therapies” in combinazione con la chemioterapia nell’“outcome” del carcinoma colo-rettale metastatico nella pratica clinica

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).