Chiara S6, Ribecco A7, Crino` L8, Andreuccetti M1, Falcone A1,2. 1U. ... secondary radical (R0) resection of metastases (15% vs 6%, p=0.03), progression-free.
session L: gastrointestinal cancer-colon-rectal Masi G1, Vasile E1, Loupakis F1, Cupini S2, Fornaro L1, Baldi G2, Salvatore L1, Stasi I1, Brunetti I3, Ricci S3, Palazzo A4, Pellegrino A4, Truscelli K4, Garrone M5, Chiara S6, Ribecco A7, Crino` L8, Andreuccetti M1, Falcone A1,2 1 U.O. Oncologia Medica 2 Universitaria, Azienda Ospedaliera-Universitaria Pisana, Istituto Toscano Tumori, Pisa (IT); 2U.O. Oncologia Medica, Azienda USL 6 di Livorno, Istituto Toscano Tumori, Livorno (IT); 3U.O. Oncologia Medica 1, Azienda Ospedaliera-Universitaria Pisana, Istituto Toscano Tumori, Pisa (IT); 4 U.O. Oncologia B, Dipartimento di Medicina Sperimentale, Universita` di Roma ‘‘Sapienza’’, Roma (IT); 5U.O. Oncologia Medica, Ospedale S. Croce e Carle, Cuneo (IT); 6U.O. Oncologia Medica, Istituto Nazionale Tumori, Genova (IT); 7S.C. Oncologia Medica, Azienda Sanitaria di Firenze, Istituto Toscano Tumori, Firenze (IT); 8U.O. Oncologia Medica, Ospedale S. Andrea delle Fratte, Perugia (IT)
L2* VEGF GENE POLYMORPHISMS IN THE PREDICTION OF BENEFIT FROM FIRST-LINE FOLFIRI PLUS BEVACIZUMAB (BV) IN METASTATIC COLORECTAL CANCER (MCRC) PATIENTS (PTS) Loupakis F1, Ruzzo A2, Salvatore L1, Canestrari E2, Cremolini C1, Masi G1, Schirripa M1, Spoto C3, Galluccio N2, Vincenzi B3, Santini D3, Bencardino K4, Ricci V4, Catalano V5, Manzoni M6, Danova M6, Tonini G3, Magnani M2, Falcone A1,7, Graziano F5 1 U.O. Oncologia Medica 2 Universitaria, Azienda Ospedaliera-Universitaria Pisana Istituto Toscano Tumori, Pisa, Italy; 2Dipartimento di Scienze Biomolecolari, Universita` degli Studi ‘‘Carlo Bo’’, Urbino, Italy; 3U.O. Oncologia Medica, Universita` Campus Biomedico, Roma, Italy; 4U.O. Oncologia Medica, Istituto Scientifico Universitario San Raffaele, Milano, Italy; 5U.O. Oncologia Medica, Ospedale di Pesaro, Italy; 6U.O. Oncologia Medica, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy; 7Dipartimento di Oncologia dei Trapianti e delle Nuove Tecnologie in Medicina, Universita` di Pisa, Italy Introduction: Addition of BV to first-line irinotecan plus 5FU improves PFS and OS of mCRC pts. Meanwhile, the anti-VEGF causes specific toxicities and increases costs of treatment. At the same time, not all pts derive an equal benefit from the VEGF inhibitor. Molecular predictors of BV efficacy have not yet been identified. Specific VEGF polymorphisms may affect gene transcription, thus indirectly influencing BV efficacy. Methods: Peripheral blood samples for genomic DNA extraction were collected from consecutive mCRC pts receiving FOLFIRI plus BV as first-line treatment (BV-group). VEGF -2578A/C, -460C/T, +405C/G, +936C/T polymorphisms were analysed by means of PCRRFLP. One-hundred-seven pts, treated with FOLFIRI alone, served as historical control group. Results: One-hundred-eleven pts were included in the BV-group. M/F=57/54, median age=63 (34-82), Ko¨hne score (low/intermediate/high/data missing)=57/39/12/3. Sixtynine out of 111 pts achieved response (RR=62%). Median PFS (mPFS) and median OS (mOS) were 10.2 and 22.2 months, respectively. -460C/C, C/T and T/T allelic variants were found in 20%, 54% and 26% of pts, respectively. -460 T allele demonstrated
L3* CONCOMITANT ANALYSIS OF KRAS, BRAF, PIK3CA MUTATIONS AND LOSS OF PTEN EXPRESSION ENHANCES PREDICTION OF CLINICAL OUTCOME TO CETUXIMAB OR PANITUMUMAB IN METASTATIC COLORECTAL CANCER Salvatore Siena1, Andrea Sartore-Bianchi1, Federica Di Nicolantonio2, Michele Nichelatti3, Francesca Molinari4, Sara De Dosso5, Piercarlo Saletti5, Miriam Martini2, Federico Pozzi1, Giovanna Marrapese1, Carolina Sarnataro1, Luca Mazzucchelli4, Simona Lamba2, Silvio Veronese6, Milo Frattini4, Alberto Bardelli2,7 1 The Falck Division of Medical Oncology, 3Service of Biostatistics, and 6 Division of Pathology, Ospedale Niguarda Ca’ Granda, Milan, Italy; 2Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment (IRCC), University of Torino Medical School, Candiolo, Turin, Italy; 4 Laboratory of Molecular Diagnostic, Istituto Cantonale di Patologia, Locarno, Switzerland; 5Oncology Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland; 7FIRC Institute of Molecular Oncology, Milan, Italy Presented in part at the 100th annual meeting of the American Association for Cancer Research, April 18-22, 2009, Denver, CO. Despite the recent recommendations by EMEA as well as by ASCO of KRAS testing as a diagnostic prerequisite for EGFR-targeted cetuximab- or panitumumab-based therapies for metastatic colorectal cancer (mCRC), the response rate to either of these drugs is limited to