PO.PS01.06 · 人群科学

WCRF/AICR建议与结肠癌生存及化疗结局的关联：CALGB/SWOG 80702（Alliance）

Associations of WCRF/AICR recommendations with survival and chemotherapy outcomes in colon cancer: CALGB/SWOG 80702 (Alliance)

编号 5038 展板 11 时间 4/21 09:00–12:00 区域 Section 35 主讲 En Cheng, MD;PhD

分会场 Diet, Alcohol, and Tobacco, and Other Lifestyle Factors

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作者与单位 Authors & Affiliations

En Cheng¹, Chao Ma², Qian Shi³, Anthony F. Shields⁴, Peter T. Campbell¹, Ardaman P. Shergill⁵, Katherine A. Guthrie⁶, Felix Couture⁷, Philip Kuebler⁸, Pankaj Kumar⁹, Benjamin Tan¹⁰, Smitha S. Krishnamurthi¹¹, Kimmie Ng², Eileen M. O'Reilly¹², Justin C. Brown¹³, Philip A. Philip⁴, Jeffrey A. Meyerhardt²

¹Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY,²Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA,³Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN,⁴Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI,⁵Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, IL,⁶SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Center, Seattle, WA,⁷Hôtel-Dieu de Québec, Quebec, QC, Canada,⁸Columbus NCI Community Oncology Research Program, Columbus, OH,⁹Illinois CancerCare PC, Peoria, IL,¹⁰Siteman Cancer Center, Washington University School of Medicine, St Louis, MO,¹¹Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH,¹²Memorial Sloan Kettering Cancer Center, Weill Cornell Medical Center, New York, NY,¹³Exercise & Cancer Biology Research Program, AdventHealth, Orlando, FL

摘要 Abstract

中文摘要

背景：据报道，遵循2018年世界癌症研究基金会（WCRF）/美国癌症研究所（AICR）癌症预防建议与长期结肠癌生存者更好的生存相关（可能受不朽时间偏倚影响）。因此，通过评估诊断后不久的遵循情况来验证生存获益十分重要，并且需要进一步研究以考察其与化疗结局的关联。方法：利用一项在III期结肠癌患者中开展的NCI资助的辅助化疗试验（CALGB/SWOG 80702；NCT01150045），我们纳入了1,666例在化疗开始时返回有效Willett食物频率问卷（FFQ）的患者，并据此推导出WCRF/AICR评分（评分越高表示遵循度越高）。主要结局为无病生存（从完成FFQ到复发或死亡的时间），次要结局为相对剂量强度降低（reduced relative dose intensity, RDI；<85%表示完成情况较差）和严重毒性（任何化疗相关毒性的≥3级）。为估计WCRF/AICR评分（四分位）与生存及化疗结局的关联，我们对无病生存进行了多变量Cox比例风险回归，对RDI降低和严重毒性进行了多变量logistic回归。结果：与WCRF/AICR评分最低四分位者相比，最高四分位患者具有显著更好的无病生存（风险比：0.75 [0.58, 0.98]，P趋势 = 0.02）和更低的RDI降低风险（比值比[OR]：0.74 [0.54, 1.00]，P趋势 = 0.03），但严重毒性方面无此关联（OR：1.24 [0.93, 1.67]，P趋势 = 0.11）。结论：在III期结肠癌患者中，较高地遵循WCRF/AICR建议与更好的生存和化疗完成相关，但与严重毒性无关。资助：https://acknowledgments.alliancefound.org 表. WCRF/AICR建议与生存及化疗结局的校正关联生存及化疗结局 Q1 Q2 Q3 Q4 P趋势无病生存事件数/风险人数 133/393 134/492 74/323 114/458 风险比 1.00 0.83 (0.65, 1.05) 0.68 (0.51, 0.91) 0.75 (0.58, 0.98) 0.02 RDI降低事件数/风险人数 156/393 191/492 131/323 208/458 比值比 1.00 0.97 (0.72, 1.30) 0.95 (0.69, 1.32) 0.74 (0.54, 1.00) 0.003 严重毒性事件数/风险人数 174/393 230/492 172/323 227/458 比值比 1.00 1.10 (0.83, 1.46) 1.41 (1.03, 1.93) 1.24 (0.93, 1.67) 0.11

查看英文原文 English abstract

Background: Adhering to 2018 World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations is reportedly associated with better survival among long-term colon cancer survivors (likely affected by immortal time bias). Thus, it is important to validate survival benefits by assessing adherence shortly after diagnosis, and further investigation is needed to examine its association with chemotherapy outcomes. Methods: Using an NCI-sponsored adjuvant chemotherapy trial conducted in patients with stage III colon cancer (CALGB/SWOG 80702; NCT01150045), we included 1,666 patients who returned valid Willett food frequency questionnaires (FFQ) at chemotherapy initiation and derived WCRF/AICR scores accordingly (higher score suggesting higher adherence). The primary outcome was disease-free survival (time from FFQ completion to recurrence or death), and secondary outcomes were reduced relative dose intensity (RDI; <85% suggesting worse completion) and severe toxicities (grade ≥3 for any chemotherapy-related toxicity). To estimate the associations of WCRF/AICR scores (quartiles) with survival and chemotherapy outcomes, we conducted multivariable Cox proportional hazards regression for disease-free survival and multivariable logistic regression for reduced RDI and severe toxicities. Results: Compared to those in the lowest quartile of the WCRF/AICR score, patients in the highest quartile had significantly better disease-free survival (hazard ratio: 0.75 [0.58, 0.98], P trend = 0.02) and lower risk of reduced RDI (odds ratio [OR]: 0.74 [0.54, 1.00], P trend = 0.03), but not for severe toxicities (OR: 1.24 [0.93, 1.67], P trend = 0.11). Conclusions: In patients with stage III colon cancer, higher adherence to WCRF/AICR recommendations was associated with better survival and chemotherapy completion, but not for severe toxicities. Funding : https://acknowledgments.alliancefound.org Table. Adjusted Associations of WCRF/AICR Recommendations with Survival and Chemotherapy Outcomes Survival and Chemotherapy Outcomes Q1 Q2 Q3 Q4 P trend Disease-free survival Number of events/at risk 133/393 134/492 74/323 114/458 Hazard ratio 1.00 0.83 (0.65, 1.05) 0.68 (0.51, 0.91) 0.75 (0.58, 0.98) 0.02 Reduced RDI Number of events/at risk 156/393 191/492 131/323 208/458 Odds ratio 1.00 0.97 (0.72, 1.30) 0.95 (0.69, 1.32) 0.74 (0.54, 1.00) 0.003 Severe toxicities Number of events/at risk 174/393 230/492 172/323 227/458 Odds ratio 1.00 1.10 (0.83, 1.46) 1.41 (1.03, 1.93) 1.24 (0.93, 1.67) 0.11

利益披露 Disclosure

E. Cheng, None.. C. Ma, None.. Q. Shi, None.. A. F. Shields, None.. P. T. Campbell, None.. A. P. Shergill, None.. K. A. Guthrie, None.. F. Couture, None.. P. Kuebler, None.. P. Kumar, None.. B. Tan, None.. S. S. Krishnamurthi, None. K. Ng, Pharmavite ). Janssen ). CytomX Other, Consultant/advisory board. Revolution Medicines Other, Consultant/advisory board. Agenus Other, Consultant/advisory board. Johnson & Johnson Other, Consultant/advisory board. AbbVie Other, Consultant/advisory board. Sanofi Other, Consultant/advisory board. Flagship Pioneering Other, Consultant/advisory board. AstraZeneca Other, Consultant/advisory board. Amgen Other, Consultant/advisory board. GlaxoSmithKline Other, Consultant/advisory board. Manta Cares Other, Consultant/advisory board. CRICO Other, Consultant/advisory board. JAMA Other, Associate Editor. E. M. O'Reilly, None.. J. C. Brown, None.. P. A. Philip, None.. J. A. Meyerhardt, None.

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