Metastatic colorectal cancer in both sides of Aegean sea: practice patterns and outcome

Abstract

Objective

The successful results obtained in trials may not necessarily translate into prolonged survival of metastatic colorectal cancer (mCRC) patients in real life. This multinational registry study aimed to evaluate the real-life data effecting the survival of patients with mCRC.

Methods

This is a multinational, retrospective registry study. Turkish and Greek mCRC patients diagnosed between 2005 and 2012, with at least 3 years of follow-up data or who died before 3 years of follow-up were included in the study.

Results

A total of 364 were included in the study. RAS and BRAF mutation rates were found to be 36% and 39%, respectively. As first-line therapy, 196 (54%) patients received bevacizumab and Anti-EGFR treatments in combination with chemotherapy. The objective response rate was 42% (n = 152) and 32% (n = 78) for 1^st line and 2^nd line treatments, respectively. While the median progression-free survival (PFS) with the 1^st line treatment was 10 months, it was 7 months with the 2^nd line treatments. In the total study population median PFS and overall survival (OS) were 10 (95% CI, 8.3–11.6) and 35 (95% CI, 30.7–39.2) months, respectively. In Turkish and Greek patients, median OS (36 months versus 29 months, p = .81) and PFS (10.2 versus 9.2, p = .42) were not different. In multivariate analysis, ECOG PS of ≥2 and having metastases in more than one region decreased overall survival (p = .002 and p = .003), it was found that wild RAS and BRAF mutations and second metastasectomy contributed to overall survival (p = .047 and p < .001).

Conclusion

In conclusion, it seems that the patient's performance status, tumor location, number of metastatic lesions at the time of diagnosis affect the prognosis of mCRC. Although access to molecular tests and first-line treatments differ between Greece and Turkey, no significant difference was found in survival times.

Keywords:

• Colorectal cancer
• Greece
• Turkey
• panitumumab
• cetuximab
• bevacizumab

Transparency

Declaration of funding

This paper was not funded.

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors contributed to the study's conception and design. Material preparation, data collection and analysis were performed by [Ozan Yazıcı], [Gökhan Uçar], [Birol Yıldız] [Osman Sütcüoğlu] [Michalis Karamouzis] [Hüseyin Abalı]. The first draft of the manuscript was written by [Ozan Yazıcı], and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Data availability statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethics statement

Ethical approval was waived by the Ethics Committee of Ankara Numune Education and Research Hospital in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.