Panitumumab Use in Metastatic Colorectal Cancer and Patterns of KRAS Testing: Results from a Europe-Wide Physician Survey and Medical Records Review.
BACKGROUND
From 2008-2013, the European indication for panitumumab required that patients' tumor KRAS exon 2 mutation status was known prior to starting treatment. To evaluate physician awareness of panitumumab prescribing information and how physicians prescribe panitumumab in patients with metastatic colorectal cancer (mCRC), two European multi-country, cross-sectional, observational studies were initiated in 2012: a physician survey and a medical records review. The first two out of three planned rounds for each study are reported.


METHODS
The primary objective in the physician survey was to estimate the prevalence of KRAS testing, and in the medical records review, it was to evaluate the effect of test results on patterns of panitumumab use. The medical records review study also included a pathologists' survey.


RESULTS
In the physician survey, nearly all oncologists (299/301) were aware of the correct panitumumab indication and the need to test patients' tumor KRAS status before treatment with panitumumab. Nearly all oncologists (283/301) had in the past 6 months of clinical practice administered panitumumab correctly to mCRC patients with wild-type KRAS status. In the medical records review, 97.5% of participating oncologists (77/79) conducted a KRAS test for all of their patients prior to prescribing panitumumab. Four patients (1.3%) did not have tumor KRAS mutation status tested prior to starting panitumumab treatment. Approximately one-quarter of patients (85/306) were treated with panitumumab and concurrent oxaliplatin-containing chemotherapy; of these, 83/85 had confirmed wild-type KRAS status prior to starting panitumumab treatment. All 56 referred laboratories that participated used a Conformité Européenne-marked or otherwise validated KRAS detection method, and nearly all (55/56) participated in a quality assurance scheme.


CONCLUSIONS
There was a high level of knowledge amongst oncologists around panitumumab prescribing information and the need to test and confirm patients' tumors as being wild-type KRAS prior to treatment with panitumumab, with or without concurrent oxaliplatin-containing therapy.
University Hospital, Frankfurt, Germany.
Jörg
J
Trojan
Institute Sainte Catherine, Avignon, France.
Laurent
L
Mineur
Masaryk Memorial Cancer Institute, Brno, Czech Republic.
Jiří
J
Tomášek
Curie Institute, Paris, France.
Etienne
E
Rouleau
Masaryk Memorial Cancer Institute, Brno, Czech Republic.
Pavel
P
Fabian
University and General Hospital, Udine, Italy.
Giovanna
G
de Maglio
Gregorio Marañón Hospital, Madrid, Spain.
Pilar
P
García-Alfonso
University and General Hospital, Udine, Italy.
Giuseppe
G
Aprile
Amgen Ltd, Uxbridge, UK.
Aliki
A
Taylor
Amgen Ltd, Uxbridge, UK.
George
G
Kafatos
Amgen Ltd, Uxbridge, UK.
Gerald
G
Downey
Amgen (Europe) GmbH, Zug Switzerland.
Jan-Henrik
JH
Terwey
Radboud University Medical Center, Nijmegen, Netherlands.
J Han
JH
van Krieken
D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D003710:Demography; D005060:Europe; D005091:Exons / Q000235:genetics; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008499:Medical Records; D000077544:Panitumumab; D010820:Physicians; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics*; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; C117307:KRAS protein, human; D000077544:Panitumumab; D016283:Proto-Oncogene Proteins p21(ras)