BACKGROUND: Therapy with anti-epidermal growth factor receptor (egfr) monoclonal antibody improves outcomes for patients with metastatic colorectal cancer (mcrc) in the first-, second-, and third-line trial settings. In British Columbia, the use of egfr inhibitors (egfris) is confined to third-line therapy, which might lower the proportion of patients who receive this therapy. The objective of the present study was to describe egfri treatment patterns when those agents are limited to the third-line setting. The results will inform decisions about optimal use of egfri agents, including earlier in the course of therapy for metastatic disease. METHODS: All patients with newly diagnosed mcrc who were referred to BC Cancer Agency clinics in 2009 were included in the study. Prognostic and treatment information was prospectively collected; KRAS test results were determined by chart review. RESULTS: The study included 443 patients with a median age of 66 years. For the 321 patients who received systemic therapy, median survival was 22.3 months. Of the 117 patients who were treated with 5-fluorouracil, oxaliplatin, and irinotecan, and who were potentially eligible for egfri therapy, 90% (105 patients) were tested for KRAS status. Of the 60 patients with KRAS wild-type tumours, 82% (49 patients) received egfri therapy. CONCLUSIONS: When egfri therapy is limited to the third-line setting, only a small proportion of patients receive such therapy, with death and poor performance status preventing its use in the rest. Availability of egfri in earlier lines of therapy could increase the proportion of patients treated with all active systemic agents.
BACKGROUND: Therapy with anti-epidermal growth factor receptor (egfr) monoclonal antibody improves outcomes for patients with metastatic colorectal cancer (mcrc) in the first-, second-, and third-line trial settings. In British Columbia, the use of egfr inhibitors (egfris) is confined to third-line therapy, which might lower the proportion of patients who receive this therapy. The objective of the present study was to describe egfri treatment patterns when those agents are limited to the third-line setting. The results will inform decisions about optimal use of egfri agents, including earlier in the course of therapy for metastatic disease. METHODS: All patients with newly diagnosed mcrc who were referred to BC Cancer Agency clinics in 2009 were included in the study. Prognostic and treatment information was prospectively collected; KRAS test results were determined by chart review. RESULTS: The study included 443 patients with a median age of 66 years. For the 321 patients who received systemic therapy, median survival was 22.3 months. Of the 117 patients who were treated with 5-fluorouracil, oxaliplatin, and irinotecan, and who were potentially eligible for egfri therapy, 90% (105 patients) were tested for KRAS status. Of the 60 patients with KRAS wild-type tumours, 82% (49 patients) received egfri therapy. CONCLUSIONS: When egfri therapy is limited to the third-line setting, only a small proportion of patients receive such therapy, with death and poor performance status preventing its use in the rest. Availability of egfri in earlier lines of therapy could increase the proportion of patients treated with all active systemic agents.
Authors: Jean-Yves Douillard; Kelly S Oliner; Salvatore Siena; Josep Tabernero; Ronald Burkes; Mario Barugel; Yves Humblet; Gyorgy Bodoky; David Cunningham; Jacek Jassem; Fernando Rivera; Ilona Kocákova; Paul Ruff; Maria Błasińska-Morawiec; Martin Šmakal; Jean Luc Canon; Mark Rother; Richard Williams; Alan Rong; Jeffrey Wiezorek; Roger Sidhu; Scott D Patterson Journal: N Engl J Med Date: 2013-09-12 Impact factor: 91.245
Authors: Richard M Goldberg; Mace L Rothenberg; Eric Van Cutsem; Al B Benson; Charles D Blanke; Robert B Diasio; Axel Grothey; Heinz-Josef Lenz; Neal J Meropol; Ramesh K Ramanathan; Carlos H Roberto Becerra; Rita Wickham; Delma Armstrong; Carol Viele Journal: Oncologist Date: 2007-01
Authors: C Bokemeyer; I Bondarenko; J T Hartmann; F de Braud; G Schuch; A Zubel; I Celik; M Schlichting; P Koralewski Journal: Ann Oncol Date: 2011-01-12 Impact factor: 32.976
Authors: Eric Van Cutsem; Claus-Henning Köhne; István Láng; Gunnar Folprecht; Marek P Nowacki; Stefano Cascinu; Igor Shchepotin; Joan Maurel; David Cunningham; Sabine Tejpar; Michael Schlichting; Angela Zubel; Ilhan Celik; Philippe Rougier; Fortunato Ciardiello Journal: J Clin Oncol Date: 2011-04-18 Impact factor: 44.544
Authors: Volker Heinemann; Ludwig Fischer von Weikersthal; Thomas Decker; Alexander Kiani; Ursula Vehling-Kaiser; Salah-Eddin Al-Batran; Tobias Heintges; Christian Lerchenmüller; Christoph Kahl; Gernot Seipelt; Frank Kullmann; Martina Stauch; Werner Scheithauer; Jörg Hielscher; Michael Scholz; Sebastian Müller; Hartmut Link; Norbert Niederle; Andreas Rost; Heinz-Gert Höffkes; Markus Moehler; Reinhard U Lindig; Dominik P Modest; Lisa Rossius; Thomas Kirchner; Andreas Jung; Sebastian Stintzing Journal: Lancet Oncol Date: 2014-07-31 Impact factor: 41.316
Authors: Howard S Hochster; Weixiu Luo; Elizabeta C Popa; Bruce T Lyman; Mary Mulcahy; Peter A Beatty; Al Bowen Benson Journal: J Clin Oncol Date: 2007-12-01 Impact factor: 44.544
Authors: H Kennecke; S Berry; J Maroun; P Kavan; N Aucoin; F Couture; M Poulin-Costello; B Gillesby Journal: Curr Oncol Date: 2019-12-01 Impact factor: 3.677