Prognosis and molecular characteristics of IBD-associated colorectal cancer: Experience from a French tertiary-care center.
Colorectal cancer
Inflammatory bowel disease
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
received:
07
11
2022
revised:
10
02
2023
accepted:
16
02
2023
medline:
28
8
2023
pubmed:
6
3
2023
entrez:
5
3
2023
Statut:
ppublish
Résumé
Little is known about the prognosis of colorectal cancer associated with inflammatory bowel disease (CRC-IBD) in a real-world cohort in France. We conducted a retrospective observational study including all patients presenting CRC-IBD in a French tertiary center. Among 6510 patients, the rate of CRC was 0.8% with a median delay of 19.5 years after IBD diagnosis (median age 46 years, ulcerative colitis 59%, initially localized tumor 69%). There was a previous exposure to immunosuppressants (IS) in 57% and anti-TNF in 29% of the cases. A RAS mutation was observed in only 13% of metastatic patients. OS of the whole cohort was 45 months. OS and PFS of synchronous metastatic patients was 20.4 months and 8.5 months respectively. Among the patients with localized tumor those previously exposed to IS had a better PFS (39 months vs 23 months; p = 0.05) and OS (74 vs 44 months; p = 0.03). The IBD relapse rate was 4%. No unexpected chemotherapy side-effect was observed CONCLUSIONS: OS of CRC-IBD is poor in metastatic patients although IBD is not associated with under-exposure or increased toxicity to chemotherapy. Previous IS exposure may be associated with a better prognosis.
Sections du résumé
BACKGROUND
Little is known about the prognosis of colorectal cancer associated with inflammatory bowel disease (CRC-IBD) in a real-world cohort in France.
METHODS
We conducted a retrospective observational study including all patients presenting CRC-IBD in a French tertiary center.
RESULTS
Among 6510 patients, the rate of CRC was 0.8% with a median delay of 19.5 years after IBD diagnosis (median age 46 years, ulcerative colitis 59%, initially localized tumor 69%). There was a previous exposure to immunosuppressants (IS) in 57% and anti-TNF in 29% of the cases. A RAS mutation was observed in only 13% of metastatic patients. OS of the whole cohort was 45 months. OS and PFS of synchronous metastatic patients was 20.4 months and 8.5 months respectively. Among the patients with localized tumor those previously exposed to IS had a better PFS (39 months vs 23 months; p = 0.05) and OS (74 vs 44 months; p = 0.03). The IBD relapse rate was 4%. No unexpected chemotherapy side-effect was observed CONCLUSIONS: OS of CRC-IBD is poor in metastatic patients although IBD is not associated with under-exposure or increased toxicity to chemotherapy. Previous IS exposure may be associated with a better prognosis.
Identifiants
pubmed: 36872200
pii: S1590-8658(23)00225-6
doi: 10.1016/j.dld.2023.02.011
pii:
doi:
Substances chimiques
Tumor Necrosis Factor Inhibitors
0
Immunosuppressive Agents
0
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1280-1287Informations de copyright
Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest MA received grant supports from Innate Pharma, Janssen, Takeda, Genentech/Roche, and honoraria for teaching activities or consultancy from Abbvie, Amgen, Biogen, Boehringer-Ingelheim, Bristol Myers Squibb, Celgene, Celltrion, Ferring, Genentech, Gilead, IQVIA, Janssen, Novartis, Pfizer, Roche, Takeda, Tillots. T.A. presented conferences for Shire, Ipsen, Amgen, BMS, Servier, Pfizer, Roche Sanofi and meeting grants for Ipsen, Novartis, Roche and Hospira. He also obtained research grant from Novartis and Innate Pharma. N.H. received honoraria for consultancy from Janssen and Takeda. M.L.T.M. received honoraria from Abbvie and Janssen. J.M.G. has been a speaker and/advisory board member for Abbvie, Amgen, Celltrion, Takeda, Janssen and Sanofi Genzyme. N.L. has been a speaker for Sanofi. J.L.C., J.L., M.A., L.M., C.B., N.A., B.P., and H.C. have no conflict of interest to declare.