Gianluca Mauri1, Elio Gregory Pizzutilo1, Alessio Amatu2, Katia Bencardino2, Laura Palmeri2, Erica Francesca Bonazzina2, Federica Tosi2, Giulia Carlo Stella2, Giovanni Burrafato2, Francesco Scaglione1, Silvia Marsoni3, Giulia Siravegna4, Alberto Bardelli4, Salvatore Siena1, Andrea Sartore-Bianchi5. 1. Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy; Università degli Studi di Milano, Dipartimento di Oncologia ed Emato-Oncologia, Milano, Italy. 2. Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy. 3. Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy; FIRC Institute of Molecular Oncology (IFOM), Milan, Italy. 4. Candiolo Cancer Insitute - FPO, IRCCS, Candiolo, Turin, Italy; Department of Oncology, University of Torino, Candiolo, Turin, Italy. 5. Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy; Università degli Studi di Milano, Dipartimento di Oncologia ed Emato-Oncologia, Milano, Italy. Electronic address: andrea.sartorebianchi@unimi.it.
Abstract
BACKGROUND: Despite advances in precision oncology and immunotherapy of tumors, little progress has been made in metastatic colorectal cancer (mCRC) in recent years. Therefore, making the most of available therapies is a necessity. Several studies, based on the pulsatile behavior of RAS clones under EGFR blockade, investigated whether readministration of EGFR-targeted agents is effective beyond second line. METHODS: A systematic review of studies of retreatment with anti-EGFR monoclonal antibodies has been performed from January 2005 to December 2018 according to PRISMA criteria from PubMed, ESMO and ASCO meetings libraries and Clinicaltrial.gov. Efficacy has been evaluated as objective response rate and survival in available publications. In addition, type and incidence of side effects occurring during on anti-EGFR retreatment have been considered. RESULTS: 26 publications have been retrieved, of which 20 full-text articles and 6 abstracts and categorized as for the retreatment strategy into five groups: rechallenge (n = 10), reintroduction (n = 4), sequence (n = 5), dose escalation (n = 1) and mixed (n = 6). Data of efficacy displayed high heterogeneity across different strategies (objective response rate, ORR = 0.0-53.8%; disease control rate, DCR = 24.0-89.7%), with best results in the setting of rechallenge (ORR = 2.9-53.8%; DCR = 40.0-89.7%). CONCLUSIONS: Rechallenge with anti-EGFR provides clinical benefit in molecularly selected mCRC patients beyond second line. Further ctDNA-guided studies comparing this option of treatment with current approved advanced line treatments are warranted.
BACKGROUND: Despite advances in precision oncology and immunotherapy of tumors, little progress has been made in metastatic colorectal cancer (mCRC) in recent years. Therefore, making the most of available therapies is a necessity. Several studies, based on the pulsatile behavior of RAS clones under EGFR blockade, investigated whether readministration of EGFR-targeted agents is effective beyond second line. METHODS: A systematic review of studies of retreatment with anti-EGFR monoclonal antibodies has been performed from January 2005 to December 2018 according to PRISMA criteria from PubMed, ESMO and ASCO meetings libraries and Clinicaltrial.gov. Efficacy has been evaluated as objective response rate and survival in available publications. In addition, type and incidence of side effects occurring during on anti-EGFR retreatment have been considered. RESULTS: 26 publications have been retrieved, of which 20 full-text articles and 6 abstracts and categorized as for the retreatment strategy into five groups: rechallenge (n = 10), reintroduction (n = 4), sequence (n = 5), dose escalation (n = 1) and mixed (n = 6). Data of efficacy displayed high heterogeneity across different strategies (objective response rate, ORR = 0.0-53.8%; disease control rate, DCR = 24.0-89.7%), with best results in the setting of rechallenge (ORR = 2.9-53.8%; DCR = 40.0-89.7%). CONCLUSIONS: Rechallenge with anti-EGFR provides clinical benefit in molecularly selected mCRC patients beyond second line. Further ctDNA-guided studies comparing this option of treatment with current approved advanced line treatments are warranted.
Authors: Thomas Walter; Neil S Hawkins; Richard F Pollock; Fabien Colaone; Suki Shergill; Paul J Ross Journal: J Cancer Res Clin Oncol Date: 2020-07-27 Impact factor: 4.553
Authors: Barbara Manzanares-Martin; Arancha Cebrián Aranda; Laura Del Puerto-Nevado; Rafael González; Sonia Solanes; Maria Auxiliadora Gómez-España; Jesús García-Foncillas; Enrique Aranda Journal: J Immunother Cancer Date: 2021-04 Impact factor: 13.751