Colorectal Cancer Metastatic Clinical Trial
Official title:
Age, Body Mass Index and Tumor Sidedness in Metastatic Colorectal Cancer Patients as Predictive Factors for Systemic Therapy Outcome
To determine progression free survival (PFS) and overall survival (OS) in metastatic colorectal cancer in relation to age, BMI and tumor sidedness, describing their predictive influence on systemic therapy outcome.
Colorectal cancer (CRC) represents a major public health concern as it is the third most
frequently diagnosed cancer and the fourth cause of cancer-related mortality worldwide . The
five-year survival rate is around 64.9% for all stages, while in metastatic cases, it only
reaches 13.1% .
Approximately 26% of CRCs are diagnosed at stage IV among patients aged younger than 50
years, compared with 23% in those aged 50 to 64 years and 19% among those aged 65 years and
older. Overall survival (OS) among patients younger than 50 years (68%) is similar to that in
those 50 to 64 years (69%) because of a later stage at diagnosis.
Obesity is associated with an increased incidence of CRC . In recent studies body mass index
(BMI) was prognostic for overall survival and progression free survival. That is risk of
progression and/or death was greatest for low BMI; risk decreased as BMI increased. BMI was
not predictive of treatment effect . Cachexia and associated poor performance status have
previously been identified as negative prognostic factors in patients with CRC.
Tumor sidedness is an independent prognostic factor in patients with early and metastatic CRC
as left-sided primaries have improved outcomes. sidedness also represents a powerful
predictor of benefit from anti epidermal growth factor receptor[EGFR] inhibitors therapies in
patients with RAS wild-type metastatic CRC (mCRC) .
The mainstay of treatment of mCRC includes cytotoxic chemotherapy with the addition of a
molecularly targeted agent . The cytotoxic regimens that are usually used include a
combination of oxaliplatin or irinotecan with a fluoropyrimidine, in addition to targeted
agents such as [EGFR] inhibitors for patients with RAS wild-type mCRC or vascular endothelial
growth factor inhibitors .
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