Preliminary Clinical and Pathologic Characteristics of Patients Treated in Second-Line (2l) with 25 Cycles (cy) or More of Folfiri Aflibercept (Fa)

e15023 Background: Studies in 2L metastatic colorectal cancer (mCRC) have survival ranging around 10-14 months (m). No study has averaged over 10cy. In daily practice, there is a subset of patients (pt) treated with FA with unknown characteristics receiving a number of cy higher than the average numbers of cy from the clinical trials. Chau et al. identified best-responders as those with ECOG0 with any metastatic site (MS) and those with ECOG1 with only one MS, but the number of cy received is unknown. Materials and Methods: Retrospective analysis based on the clinical records of Spanish mCRC pt receiving ≥ 25cy in 2L with FA to identify clinical and pathological features. Analyses were performed with SPSS (Statistical Package for the Social Science) for the progression-free survival (PFS) and overall survival (OS) curves. Results: Eighteen patients (male/female 9/9) were identified. Median age: 56years (39-68). All tumors were located in left colon: rectum 10pt, sigma 6pt, left 2pt. Histologic grade was well or moderately differenciate in 12pt. 7 pts had perineural or vascular invasion. RAS was mutated in 13pt and wild type in 5pt. Disease characteristics in 1L: MS at first diagnostic: 1 in 9pt (liver only 7pt, liver+other 7pt, lung only 1pt, lung+other 2pt). Oxaliplatin based CT was the treatment in 1L. Objective response rate (ORR) 77,8%. Bevacizumab was given in 12pt, anti-EGFR in 4pt. 1L PFS was 16.03m (15.14-16.91). 8 pts were resected from their metastases. Starting 2L: ECOG0 13pt; ECOG1 5pt (all with more than 1 MS). Number of MS: 1 in 6pt. (lung only 4pt, lung+other 8pt, liver+other 4pt). ORR was 61,1%. Median cy administred: CT 30 (12-50), Aflibercept 34 (25-50). Doses modification: CT 14pt, Aflibercept 4pt. OS 2L with 14 pt ongoing: 28.74m (25.85-31.64). Global OS since diagnosis: 46,67m (42,99-50,36). Conclusions: Long treatment duration can be achieved with FA, independently of the ECOG or the number of MS. In this series, all patients had a left-sided tumor and were mostly RAS mutant. The safety is in line with the VELOUR trial. Tumor location should be evaluated as a potential predictive factor. Funded by sanofi