title: Efficacy of continued cetuximab for unresectable metastatic colorectal cancer after disease progression during first-line cetuximab-based chemotherapy: a retrospective cohort study.
abstract: This study assessed second-line continued use of cetuximab for treatment of unresectable metastatic colorectal cancer (mCRC) after disease progression during first-line cetuximab-based therapy. Consecutive patients with wild-type KRAS exon 2 and unresectable mCRC were retrospectively enrolled after disease progression during first-line cetuximab-based chemotherapy. Second-line continued cetuximab plus changed chemotherapy (cetuximab continuation group, n = 102) was compared with changed chemotherapy only (chemotherapy only group, n = 96) with respect to treatment efficacy and safety endpoints. NRAS and other KRAS genotypes were also detected as a post hoc analysis. The cetuximab continuation group showed better progression-free survival (median, 6.3 vs. 4.5 months, P = 0.004), overall survival (median, 17.3 vs. 14.0 months, P < 0.001) and disease control rate (70.6% vs. 53.1%, P = 0.011), and a potentially better overall response rate (18.6% vs. 9.4%, P = 0.062) than the chemotherapy only group. These benefits were seen mainly in patients with all RAS wild-type and exhibiting first-line early tumor shrinkage (ETS). For patients with other RAS mutations or who did not achieve first-line ETS, there was no difference between the two groups. These findings suggest that for patients with all RAS wild-type and unresectable mCRC who had disease progression during first-line cetuximab-based treatment, second-line continued cetuximab is effective. Moreover, ETS during first-line cetuximab-based treatment may be predictive of the efficacy of second-line continued cetuximab.
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Qingyang
authors: Q
authors: Feng
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Ye
authors: Y
authors: Wei
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Li
authors: L
authors: Ren
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Peng
authors: P
authors: Zheng
authors: Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Yiyi
authors: Y
authors: Yu
authors: Department of Liver Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Qinghai
authors: Q
authors: Ye
authors: Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Jianyong
authors: J
authors: Ding
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Jingwen
authors: J
authors: Chen
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Wenju
authors: W
authors: Chang
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Yunshi
authors: Y
authors: Zhong
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Dexiang
authors: D
authors: Zhu
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Qi
authors: Q
authors: Lin
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Liangliang
authors: L
authors: Yang
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Xinyu
authors: X
authors: Qin
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Jianmin
authors: J
authors: Xu
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D000068818:Cetuximab / Q000008:administration & dosage*; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D018450:Disease Progression; D004334:Drug Administration Schedule; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics; D012189:Retrospective Studies
chemical_list: C117307:KRAS protein, human; D009944:Organoplatinum Compounds; D016283:Proto-Oncogene Proteins p21(ras); D000068818:Cetuximab; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin
keywords: cetuximab; colorectal cancer; cross-line treatment; early tumor shrinkage; metastasis