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Second-line Cetuximab/Irinotecan Versus Oxaliplatin/Fluoropyrimidines for Metastatic Colorectal Cancer with Wild-type KRAS.
MedLine Citation:
PMID:  23298313     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The goal of the present study was to compare the combination of cetuximab and irinotecan to the combination of oxaliplatin and fluoropyrimidines as second-line chemotherapy in patients with irinotecan-refractory and oxaliplatin-naïve metastatic colorectal cancer (mCRC) harbouring wild-type KRAS. The study included 120 patients with mCRC who had progressed after irinotecan-containing first-line chemotherapy and were never treated with oxaliplatin; 40 patients with wild-type KRAS were accrued prospectively in the experimental arm (arm A), and 80 patients accrued retrospectively were divided into control arms B (n=46) and C (n=34) according to KRAS genotype. Second-line treatments consisted of cetuximab plus irinotecan for arm A, and oxaliplatin plus either 5-fluorouracil (FOLFOX) or capecitabine (CapeOX) for the control arms. The median progression-free survival (PFS) was 8.3, 5.8 and 3.9 months, for arms A, B, and C, respectively, with statistical significance favouring arm A (p=0.007). Differences in overall survival (OS) did not reach statistical significance (18.3 vs. 12.6 vs. 12.9, p=0.138), although there was a trend toward longer OS in arm A. In terms of benefit from oxaliplatin-containing regimens either as second- or third-line therapy, the median PFS was 5.0 months in arms B and C as second-line, and 4.0 months in arm A as third-line therapy, with no statistical significance (p=0.385). Second-line cetuximab plus irinotecan is a valid treatment strategy for mCRC patients with irinotecan-refractory and oxaliplatin-naïve tumours harbouring wild-type KRAS. Oxaliplatin-containing chemotherapy recorded equivalent PFS both as second-line and third-line therapy, permitting to delay FOLFOX and CapeOX until subsequent treatment cycles.
Authors:
Yong Sang Hong; Hwa Jung Kim; Seong Joon Park; Kyu-Pyo Kim; Jae-Lyun Lee; Jin Hong Park; Jong Hoon Kim; Seok-Byung Lim; Chang Sik Yu; Jin Cheon Kim; Ji Yeon Baek; Sun Young Kim; Tae Won Kim
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-9
Journal Detail:
Title:  Cancer science     Volume:  -     ISSN:  1349-7006     ISO Abbreviation:  Cancer Sci.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101168776     Medline TA:  Cancer Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 Japanese Cancer Association.
Affiliation:
Department of Oncology, University of Ulsan College of Medicine.
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