First-line cetuximab-based chemotherapies for patients with advanced or metastatic KRAS wild-type colorectal cancer

Uemura,Mamoru; Kim,Ho  Min; Hata,Tsuyoshi; Sakata,Kazuya; Okuyama,Masaki; Takemoto,Hiroyoshi; Fujii,Hitoshi; Fukuzaki,Takayuki; Morita,Tetsushi; Hata,Taishi; Takemasa,Ichiro; Satoh,Taroh; Mizushima,Tsunekazu; Doki,Yuichiro; Mori,Maski

doi:10.3892/mco.2016.938

First-line cetuximab-based chemotherapies for patients with advanced or metastatic KRAS wild-type colorectal cancer

Authors:
- Mamoru Uemura
- Ho Min Kim
- Tsuyoshi Hata
- Kazuya Sakata
- Masaki Okuyama
- Hiroyoshi Takemoto
- Hitoshi Fujii
- Takayuki Fukuzaki
- Tetsushi Morita
- Taishi Hata
- Ichiro Takemasa
- Taroh Satoh
- Tsunekazu Mizushima
- Yuichiro Doki
- Maski Mori
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Affiliations: Department of Surgery, National Hospital Organization, Osaka National Hospital, Osaka 540‑0006, Japan, Department of Surgery, Osaka Rosai Hospital, Osaka 591‑8025, Japan, Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka 565‑0871, Japan, Department of Surgery, Higashiosaka City General Hospital, Osaka 578‑8588, Japan, Department of Surgery, Sakai City Medical Center, Osaka 593‑8304, Japan, Department of Surgery, Rinku General Medical Center, Osaka 598‑8577, Japan, Department of Surgery, Ikeda Municipal Hospital, Osaka 563‑8510, Japan, Department of Surgery, Nissei Hospital, Osaka 550‑0012, Japan
Published online on: June 17, 2016 https://doi.org/10.3892/mco.2016.938
Pages: 375-379

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Abstract

Colorectal cancer (CRC) is one of the most commonly occurring cancers worldwide. A burgeoning number of studies have demonstrated that the addition of cetuximab to another standard first‑line regimen markedly improves the outcome of CRC treatment. However, at present, the efficacy and safety of cetuximab‑based combination chemotherapy has not been well described in Japan. The aim of the present study was to evaluate the efficacy and safety of first‑line chemotherapies that included cetuximab for patients with advanced or metastatic Kirsten rat sarcoma viral oncogene homolog (KRAS) wild‑type CRC in Japan. This prospective multicenter observational study was conducted at 13 affiliated medical institutions. A total of 64 patients were enrolled between 2010 and 2013. The patients met the following criteria for eligibility: i) histologically confirmed, advanced or metastatic KRAS wild‑type CRC; and ii) cetuximab‑based chemotherapies administered as a first‑line treatment. First‑line cetuximab‑based treatments were administered as follows: 29 patients (45.3%) received a combination of infusional fluorouracil, leucovorin and oxaliplatin; 14 patients (21.9%) received a combination of capecitabine and oxaliplatin; and 10 patients (15.6%) received a combination of infusional fluorouracil, leucovorin and irinotecan. The overall response rate (including complete plus partial responses) was 50% (32/64 patients). Initially, 48 lesions were diagnosed as unresectable. Among those, 13 lesions (27.1%) were converted to a resectable status following cetuximab‑based combination chemotherapy treatments. The median overall survival time and the progression‑free survival time were 1,189 and 359 days, respectively. The most frequent grade 3/4 adverse event was neutropenia, which occurred in 20.3% of the patients. The incidence of grade 3/4 skin toxicity was 17.2% (11/64 patients). Cetuximab‑based therapies may represent a promising first‑line regimen for patients with advanced or metastatic KRAS wild-type CRC in Japan. In addition, this combination was associated with a low incidence of serious toxicities.

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