1. Retreatment With Anti-EGFR Antibodies in Metastatic Colorectal Cancer Patients: A Multi-institutional Analysis
- Author
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Alessandra Boccaccino, Chiara Cremolini, Michele Prisciandaro, Maria Bensi, Alfredo Falcone, Marco Maria Germani, Filippo Pagani, Daniele Rossini, Marta Schirripa, Roberto Moretto, Nicole Liscia, Mario Scartozzi, Daniele Santini, Filippo Pietrantonio, Raffaella Vivolo, Antonio Pellino, Sara Manglaviti, Lisa Salvatore, Fotios Loupakis, and Emanuela Dell'Aquila
- Subjects
Oncology ,Male ,Colorectal cancer ,Disease ,0302 clinical medicine ,Stable Disease ,Antineoplastic Agents, Immunological ,Antineoplastic Combined Chemotherapy Protocols ,Aged, 80 and over ,biology ,Gastroenterology ,Middle Aged ,Prognosis ,Progression-Free Survival ,ErbB Receptors ,Prior Therapy ,Italy ,030220 oncology & carcinogenesis ,Retreatment ,030211 gastroenterology & hepatology ,Female ,Antibody ,Chemorefractory metastatic colorectal cancer ,Circulating tumor DNA ,Liquid biopsy ,Rechallenge ,Resistance and sensitivity to anti-EGFR ,Colorectal Neoplasms ,Adult ,medicine.medical_specialty ,Clinical Decision-Making ,Disease-Free Survival ,03 medical and health sciences ,Young Adult ,Internal medicine ,medicine ,Humans ,Response Evaluation Criteria in Solid Tumors ,Aged ,Retrospective Studies ,business.industry ,Patient Selection ,Reproducibility of Results ,medicine.disease ,Regimen ,Drug Resistance, Neoplasm ,biology.protein ,Feasibility Studies ,business ,Progressive disease - Abstract
Background On the basis of retrospective analyses and phase 2 studies, metastatic colorectal cancer patients whose disease responded to a first-line regimen containing an anti–epidermal growth factor receptor (EGFR) agent may experience benefit from anti-EGFR readministration in later therapy lines. While the analysis of circulating tumor DNA seems a promising tool to select the best candidates for this strategy, identifying clinical predictors of anti-EGFR sensitivity would be useful to drive treatment choices in daily practice. Patients and Methods A real-life database of 5530 patients treated at 6 institutions was queried. Included were patients who were retreated with anti-EGFRs, who had RAS/BRAF wild-type–status tissue samples, who had received a first-line anti-EGFR–based regimen with at least stable disease as best response, and who had received at least one further line of therapy before anti-EGFR retreatment. The association with overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) of variables potentially related to anti-EGFR sensitivity was investigated. Results A total of 86 patients were identified. The ORR during anti-EGFR retreatment was 19.8%; median PFS and OS were 3.8 and 10.2 months, respectively. No significant association of clinical features of anti-EGFR sensitivity with ORR, PFS, and OS was observed. Among the 56 patients with a time from the last anti-EGFR administration to first-line progressive disease of 2 prior therapy lines and a longer anti-EGFR–free interval were associated with higher ORR, but not with longer PFS or OS. Conclusion Clinical features we deemed surrogates of anti-EGFR sensitivity were not reliable predictors of benefit from anti-EGFR retreatment.
- Published
- 2019