title: Early skin toxicity predicts better outcomes, and early tumor shrinkage predicts better response after cetuximab treatment in advanced colorectal cancer.
abstract: Cetuximab-containing treatments for metastatic colorectal cancer have been shown to have higher overall response rates and longer progression-free and overall survival than other systemic therapies. Cetuximab-related manifestations, including severe skin toxicity and early tumor shrinkage, have been shown to be predictors of response to cetuximab. We hypothesized that early skin toxicity is a predictor of response and better outcomes in patients with advanced colorectal carcinoma. We retrospectively evaluated 62 patients with colorectal adenocarcinoma who had unresectable tumors and were treated with cetuximab in our institution. Skin toxicity grade was evaluated on each treatment day. Tumor size was evaluated using computed tomography prior to treatment and 4-8 weeks after the start of treatment with cetuximab.Patients with early tumor shrinkage after starting treatment with cetuximab had a significantly higher overall response rate (P = 0.0001). Patients with early skin toxicity showed significantly longer overall survival (P = 0.0305), and patients with higher skin toxicity grades had longer progression-free survival (P = 0.0168).We have shown that early tumor shrinkage, early onset of skin toxicity, and high skin toxicity grade are predictors of treatment efficacy and/or outcome in patients with advanced colorectal carcinoma treated with cetuximab.
authors.affiliation: Department of Medical Oncology, KKR Sapporo Medical Center Tonan Hospital, Kita1-Nishi6, Chu-ou-ku, Sapporo, Hokkaido, 060-0001, Japan, tkogawa1@mdanderson.org.
authors.forename: T
authors.initials: T
authors.lastname: Kogawa
authors.forename: A
authors.initials: A
authors.lastname: Doi
authors.forename: M
authors.initials: M
authors.lastname: Shimokawa
authors.forename: T M
authors.initials: TM
authors.lastname: Fouad
authors.forename: T
authors.initials: T
authors.lastname: Osuga
authors.forename: F
authors.initials: F
authors.lastname: Tamura
authors.forename: T
authors.initials: T
authors.lastname: Mizushima
authors.forename: T
authors.initials: T
authors.lastname: Kimura
authors.forename: S
authors.initials: S
authors.lastname: Abe
authors.forename: H
authors.initials: H
authors.lastname: Ihara
authors.forename: T
authors.initials: T
authors.lastname: Kukitsu
authors.forename: T
authors.initials: T
authors.lastname: Sumiyoshi
authors.forename: N
authors.initials: N
authors.lastname: Yoshizaki
authors.forename: M
authors.initials: M
authors.lastname: Hirayama
authors.forename: T
authors.initials: T
authors.lastname: Sasaki
authors.forename: Y
authors.initials: Y
authors.lastname: Kawarada
authors.forename: S
authors.initials: S
authors.lastname: Kitashiro
authors.forename: S
authors.initials: S
authors.lastname: Okushiba
authors.forename: H
authors.initials: H
authors.lastname: Kondo
authors.forename: Y
authors.initials: Y
authors.lastname: Tsuji
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000068818:Cetuximab / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012867:Skin / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D000068818:Cetuximab