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Cetuximab plus irinotecan administered biweekly with reduced infusion time to heavily pretreated patients with metastatic colorectal cancer and related RAS and BRAF mutation status.
- Source :
-
International journal of cancer [Int J Cancer] 2021 May 15; Vol. 148 (10), pp. 2542-2556. Date of Electronic Publication: 2020 Dec 30. - Publication Year :
- 2021
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Abstract
- Metastatic colorectal cancer (mCRC) is treated with cetuximab 250 mg/m <superscript>2</superscript> administered weekly over 1 hour or biweekly (q2w) over 3.5 hours when combined with irinotecan. This prospective study investigated cetuximab 500 mg/m <superscript>2</superscript> plus irinotecan 180 mg/m <superscript>2</superscript> administered q2w over 1.5 hours independent of RAS or BRAF mutation status in mCRC patients in a third-line setting. The intention-to-treat population included 181 patients. No patients had complete response, 18% had partial responses (PR) and 48% stable disease (SD). For cetuximab, a relative dose intensity of ≥90% was reached in 78% and for irinotecan in 67% of the patients. Grade 3 to 4 toxicities were pain (17%), fatigue (9%), neutropenia (8%), diarrhea (8%), rash (8%), infection (7%) and hypersensitivity (3%). No deaths occurred. Next-generation sequencing in 96.7% of the patients revealed that 50.3% had RAS and BRAF <superscript>V600E</superscript> wild type (WT), with a mutation type (MT) in 45.1% of the RAS and 4.4% of the BRAF <superscript>V600E</superscript> genes. In patients with RAS-WT and RAS-MT tumors, a PR was obtained in 32% and 4% (P = .000003) and an SD in 43% and 53%, respectively, with a superior PFS (6.2 vs 3.7 months; hazard ratio [HR] 2.12, P = .00001) and OS (12.9 vs 8.8 months; HR 1.71, P = .0008). Treatment efficacy was poor in 7.4% of patients with an RAS mutation outside KRAS exon 2 and in 38% of patients with KRAS exon 2 mutations. Administration of cetuximab and irinotecan q2w, shortening treatment time from 3.5 to 1.5 hours, is recommended as standard therapy.<br /> (© 2020 UICC.)
Details
- Language :
- English
- ISSN :
- 1097-0215
- Volume :
- 148
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- International journal of cancer
- Publication Type :
- Academic Journal
- Accession number :
- 33336394
- Full Text :
- https://doi.org/10.1002/ijc.33448