Anti-VEGF Therapy Possibly Extends Survival in Patients With Colorectal Brain Metastasis by Protecting Patients From Neurologic Disability,Clinical Colorectal Cancer

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Anti-VEGF Therapy Possibly Extends Survival in Patients With Colorectal Brain Metastasis by Protecting Patients From Neurologic Disability
Clinical Colorectal Cancer ( IF 3.4 ) Pub Date : 2023-03-28 , DOI: 10.1016/j.clcc.2023.03.003
Chih-Wen Chen , Tao-Shen Ou , Wei-Shone Chen , Jeng-Kai Jiang , Shung-Haur Yang , Huann-Sheng Wang , Shih-Ching Chang , Yuan-Tzu Lan , Chun-Chi Lin , Hung-Hsin Lin , Sheng-Chieh Huang , Hou-Hsuan Cheng , Yi-Wen Yang , Yu-Zu Lin , Yee Chao , Ling-Wei Wang , Hao-Wei Teng

Background

Colorectal brain metastases (CBMs) are rare with poor prognosis. There is still no standard systemic treatment for multiple or unresectable CBM. our study aimed to explore the impact of anti-VEGF therapy on overall survival, brain-specific disease control, and neurologic symptom burden in patients with CBM.

Methods

A total of 65 patients with CBM under treatment were retrospectively enrolled and divided into anti-VEGF based systemic therapy or non–anti-VEGF based therapy. A total of 25 patients who received at least 3 cycles of anti-VEGF agent and 40 patients without anti-VEGF therapy were analyzed by endpoints of overall survival (OS), progression-free survival (PFS), intracranial PFS (iPFS) and neurogenic event-free survival (nEFS). Gene expression in paired primary metastatic colorectal cancer (mCRC), liver, lung and brain metastasis from NCBI data was analyzed using top Gene Ontology (GO) and cBioPortal.

Results

Patients who treated with anti-VEGF therapy had significantly longer OS (19.5 vs. 5.5 months, P = .009), iPFS (14.6 vs. 4.1 months, P < .001) and nEFS (17.6 vs. 4.4 months, P < .001). Patients who received anti-VEGF therapy beyond any disease progression presented with superior OS (19.7 vs. 9.4 months, P = .039). Top GO and cBioPortal analysis revealed a stronger molecular function of angiogenesis in intracranial metastasis.

Conclusions

Anti-VEGF based systemic therapy showed favorable efficacy that was reflected in longer overall survival, iPFS and NEFS in patients with CBM.

中文翻译：

抗 VEGF 疗法可能通过保护患者免受神经功能障碍来延长结直肠脑转移患者的生存期

背景

结直肠脑转移（CBM）很少见，预后较差。对于多发性或不可切除的 CBM 仍然没有标准的全身治疗方法。我们的研究旨在探讨抗 VEGF 治疗对 CBM 患者的总生存率、脑特异性疾病控制和神经系统症状负担的影响。

方法

回顾性纳入65例接受治疗的CBM患者，分为基于抗VEGF的全身治疗或非抗VEGF的全身治疗。共有 25 名接受至少 3 个周期抗 VEGF 药物治疗的患者和 40 名未接受抗 VEGF 治疗的患者进行了总生存期 (OS)、无进展生存期 (PFS)、颅内 PFS (iPFS) 和神经源性终点的分析。无事件生存（nEFS）。使用顶级基因本体论 (GO) 和 cBioPortal 分析来自 NCBI 数据的配对原发性转移性结直肠癌 (mCRC)、肝、肺和脑转移的基因表达。

结果

接受抗 VEGF 治疗的患者的 OS（19.5 个月与 5.5 个月，P = .009）、iPFS（14.6 个月与 4.1 个月，P < .001）和 nEFS（17.6 个月与 4.4 个月，P <.001）显着延长。 001）。在任何疾病进展后接受抗 VEGF 治疗的患者表现出优异的 OS（19.7 个月与 9.4 个月，P = 0.039）。Top GO 和 cBioPortal 分析揭示了血管生成在颅内转移中更强的分子功能。