title: Prospective analysis of KRAS wild-type patients with metastatic colorectal cancer using cetuximab plus  FOLFIRI or FOLFOX4 treatment regimens.
abstract: Cetuximab,  a monoclonal antibody targeting epidermal growth factor receptor, has proven to  be efficient in the treatment of metastatic colorectal cancer. We made a  prospective study of the efficacy and toxicities of cetuximab-combination  first-line (FOLFOX4) versus second/third-line (FOLFIRI) chemotherapy in 98 KRAS wild-type patients who had metastatic colorectal cancer. Wild-type KRAS had  been identified by direct sequencing. Associations between clinical  response/progression-free survival/overall survival/toxicities and cetuximab-combination  chemotherapy timing were evaluated. The overall response rate was  significantly higher for first-line treatment than for second/third-line  treatment (relative risk = 1.707, 95% confidence interval = 1.121-2.598). Both  progression-free survival and overall survival indicated significantly longer  survival of first-line treatment than second/third-line treatment patients.  This study is a validation of a molecular analysis of KRAS wild-type  status for the prediction of response to cetuximab-combination chemotherapy for  metastatic colorectal cancer patients; its predictive role was less prominent  in the second/third-line than in the first-line treatment patients.
authors.affiliation: Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: M Y
authors.initials: MY
authors.lastname: Huang
authors.forename: M J
authors.initials: MJ
authors.lastname: Chen
authors.forename: H L
authors.initials: HL
authors.lastname: Tsai
authors.forename: C H
authors.initials: CH
authors.lastname: Kuo
authors.forename: C J
authors.initials: CJ
authors.lastname: Ma
authors.forename: M F
authors.initials: MF
authors.lastname: Hou
authors.forename: S C
authors.initials: SC
authors.lastname: Chuang
authors.forename: S R
authors.initials: SR
authors.lastname: Lin
authors.forename: J Y
authors.initials: JY
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D000068818:Cetuximab; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000473:pathology; D004252:DNA Mutational Analysis; D018572:Disease-Free Survival; D004333:Drug Administration Routes; D004334:Drug Administration Schedule; D064420:Drug-Related Side Effects and Adverse Reactions; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000235:genetics*; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins / Q000235:genetics*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C117307:KRAS protein, human; D009944:Organoplatinum Compounds; D011518:Proto-Oncogene Proteins; D066246:ErbB Receptors; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins; D000068818:Cetuximab; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin