Li Chia Chong1, Jennifer E Hardingham1,2, Amanda R Townsend1,2, Cynthia Piantadosi3, Gonzalo Tapia Rico1, Chris Karapetis4, Rob Padbury3, Guy Maddern5, Amitesh Roy4, Timothy J Price6,7,8. 1. Department of Medical Oncology, The Queen Elizabeth Hospital, Adelaide, SA, Australia. 2. Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia. 3. Department of Surgery, Flinders Medical Centre, Bedford Park, SA, Australia. 4. Department of Medical Oncology, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia. 5. Department of Surgery, The Queen Elizabeth Hospital, Adelaide, SA, Australia. 6. Department of Medical Oncology, The Queen Elizabeth Hospital, Adelaide, SA, Australia. Timothy.Price@sa.gov.au. 7. Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia. Timothy.Price@sa.gov.au. 8. The Queen Elizabeth Hospital, TQEH Woodville Road, Woodville, SA, 5011, Australia. Timothy.Price@sa.gov.au.
Abstract
BACKGROUND: Anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (cetuximab or panitumumab) are today increasingly used in the first- or second-line setting for RAS wild-type metastatic colorectal cancer (CRC) patients. Following progression beyond third- or fourth-line therapy, some patients are unsuitable for further chemotherapy because of poor performance status or patient choice. However, a significant number of patients are still candidates for further therapy despite limited standard options being available. The role of rechallenge with anti-EGFR therapy, particularly in patients who had previously responded, is often considered, but there is limited evidence in the literature to support such a strategy. OBJECTIVE: This retrospective study aims to review the outcome of metastatic CRC patients who had anti-EGFR rechallenge. PATIENTS AND METHODS: Patients who had been rechallenged with anti-EGFR therapy were identified from the South Australian metastatic CRC database. Patient characteristics were recorded and tumor response was retrospectively assessed using Response Evaluation Criteria in Solid Tumors (RECIST). Kaplan-Meier analysis was used to assess progression free survival (PFS) for each rechallenge and overall survival (OS). RESULTS: Twenty-two patients were eligible for inclusion in this analysis. Disease control rate (stable disease and partial response) was 45.4% (ten patients) for patients who received rechallenge anti-EGFR. Seven patients received a second rechallenge and disease control rate was 28.6% (two patients). The median interval time between initial anti-EGFR therapy and rechallenge was 13.5 months. The median PFS after rechallenge 1 was 4.1 months and after rechallenge 2 was 3.5 months. The median OS was 7.7 months from date of rechallenge. CONCLUSIONS: Anti-EGFR rechallenge provides clinical benefit in patients with RAS wild-type metastatic CRC.
BACKGROUND: Anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (cetuximab or panitumumab) are today increasingly used in the first- or second-line setting for RAS wild-type metastatic colorectal cancer (CRC) patients. Following progression beyond third- or fourth-line therapy, some patients are unsuitable for further chemotherapy because of poor performance status or patient choice. However, a significant number of patients are still candidates for further therapy despite limited standard options being available. The role of rechallenge with anti-EGFR therapy, particularly in patients who had previously responded, is often considered, but there is limited evidence in the literature to support such a strategy. OBJECTIVE: This retrospective study aims to review the outcome of metastatic CRC patients who had anti-EGFR rechallenge. PATIENTS AND METHODS: Patients who had been rechallenged with anti-EGFR therapy were identified from the South Australian metastatic CRC database. Patient characteristics were recorded and tumor response was retrospectively assessed using Response Evaluation Criteria in Solid Tumors (RECIST). Kaplan-Meier analysis was used to assess progression free survival (PFS) for each rechallenge and overall survival (OS). RESULTS: Twenty-two patients were eligible for inclusion in this analysis. Disease control rate (stable disease and partial response) was 45.4% (ten patients) for patients who received rechallenge anti-EGFR. Seven patients received a second rechallenge and disease control rate was 28.6% (two patients). The median interval time between initial anti-EGFR therapy and rechallenge was 13.5 months. The median PFS after rechallenge 1 was 4.1 months and after rechallenge 2 was 3.5 months. The median OS was 7.7 months from date of rechallenge. CONCLUSIONS: Anti-EGFR rechallenge provides clinical benefit in patients with RAS wild-type metastatic CRC.
Authors: Richard M Goldberg; Clara Montagut; Zev A Wainberg; Philippe Ronga; François Audhuy; Julien Taieb; Sebastian Stintzing; Salvatore Siena; Daniele Santini Journal: ESMO Open Date: 2018-05-05
Authors: Martin S Schulz; Sebastian Wolf; Vera Struck; Niklas Thomas; Gabriele Husman; Stefan Zeuzem; Christine Koch; Jörg Trojan; Andreas Anton Schnitzbauer; Wolf Otto Bechstein; Oliver Waidmann Journal: Cancers (Basel) Date: 2022-03-24 Impact factor: 6.639