Anti-EGFR–Based Treatment of Patients with Metastatic Colorectal Cancer: Data from the National Oncology Institute of Panama

Kayra Sánchez-Muñoz; José Pinto-Llerena

doi:doi:10.11648/j.ijcocr.20220702.14

| Peer-Reviewed

Anti-EGFR–Based Treatment of Patients with Metastatic Colorectal Cancer: Data from the National Oncology Institute of Panama

Kayra Sánchez-Muñoz, José Pinto-Llerena

Published in International Journal of Clinical Oncology and Cancer Research (Volume 7, Issue 2)

Received: 31 March 2022 Accepted: 25 April 2022 Published: 12 May 2022

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Treatments directed against EGFR, such as anti-VEGF monoclonal antibodies (bevacizumab) and anti-EGFR cetuximab or panitumumab, improve clinical outcomes in terms of overall survival and disease-free survival when combined with first-line chemotherapy treatments for metastatic colon cancer. Aims. To determine the epidemiological, clinical, and survival-related variables associated with the treatment of KRAS wild-type metastatic colon cancer with anti-EGFR agents in our institution. Patients & methods. We performed a retrospective review of the electronic files of patients with KRAS wild-type metastatic colon cancer treated with cetuximab between 2014 and 2019. Results. 169 patients diagnosed with metastatic Colorectal Cancer RAS WT receiving anti-EGFR treatment. The median age was 65 years, with 54% male. 91% with ECOG 0 – 1. KRAS test was performed to 100% of patients. 70% had a tumor on the left side of the colon. Objective response was 4.8%. The median PFS was 3 months and median OS was 5 months. Only the use of combined schemes such as FOLFIRI with cetuximab and exposure to cetuximab in some lines of treatment were shown to be significant prognostic factors for PFS, compared with those who did not receive it. Rash G1-2 was the most common adverse event. Conclusions. the epidemiological and clinical characteristics of our patients are like the world literature, however, the PFS and OS reached are lower than expected as well as adverse events registered. Most of the patients received anti-EGFR treatment in second line. These results allowed us to propose anti-EGFR treatment in colorectal cancer from the front line at the National Oncology Institute.

Published in	International Journal of Clinical Oncology and Cancer Research (Volume 7, Issue 2)
DOI	10.11648/j.ijcocr.20220702.14
Page(s)	35-40
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Colorectal Cancer, Metastatic, KRAS Wild-Type, Anti-EGFR, Progression-Free Survival, Overall Survival

References

[1]	Dekker E, Tanis PJ, Vleugels JLA, Kasi PM, Wallace MB. Colorectal cancer. Lancet. 394 (10207), 1467–1480 (2019).
[2]	REGISTRO HOSPITALARIO DE CÁNCER RHC-ION. Boletín 2019.
[3]	Del RN, Panam NDE. República de Panamá Ministerio de Salud Dirección de Planificación de Salud Departamento de Registros y Estadísticas de Salud REGISTRO NACIONAL DEL CÁNCER BOLETÍN ESTADÍSTICO. 2014-6, (2012).
[4]	Porru M, Pompili L, Caruso C, Biroccio A, Leonetti C. Targeting KRAS in metastatic colorectal cancer: current strategies and emerging opportunities. J. Exp. Clin. Cancer. Res. 37 (1), 57 (2018). This review highlights the emerging experimental strategies for blocking KRAS function and signaling its direct targeting.
[5]	Xie Y-H, Chen Y-X, Fang J-Y. Comprehensive review of targeted therapy for colorectal cancer. Signal Transduct. Target. Ther. 5 (1), 22 (2020). The authors provide an overview of existing CRC-targeted agents and their underlying mechanisms, as well as a discussion of their limitations and future trends.
[6]	Li QH, Wang YZ, Tu J et al. Anti-EGFR therapy in metastatic colorectal cancer: mechanisms and potential regimens of drug resistance. Gastroenterol. Rep. (Oxf). 8 (3), 179–191 (2020).
[7]	Cunningham D, Humblet Y, Siena S et al. Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. N. Engl. J. Med. 351 (4), 337–345 (2004).
[8]	Van Cutsem E, Köhne C-H, Hitre E et al. Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N. Engl. J. Med. 360 (14), 1408–1417 (2009).
[9]	Douillard JY, Siena S, Cassidy J et al. Final results from PRIME: randomized phase III study of panitumumab with FOLFOX4 for first-line treatment of metastatic colorectal cancer. Ann. Oncol. 25 (7), 1346–1355 (2014).
[10]	Sobrero AF, Maurel J, Fehrenbacher L et al. EPIC: Phase III trial of cetuximab plus irinotecan after fluoropyrimidine and oxaliplatin failure in patients with metastatic colorectal cancer. J. Clin. Oncol. 26 (14), 2311–2319 (2008). Cetuximab and irinotecan improved progression-free survival and response rate and led to better quality of life than irinotecan alone.
[11]	Passardi A, Scarpi E, Gelsomino F et al. Impact of second line cetuximab-containing therapy in patients with KRAS wild-type metastatic colorectal cancer: Results from the ITACa randomized clinical trial. Sci. Rep. 7 (1), 10246 (2017). Results from the ITACa trial showed that, in patients with wild-type KRAS metastatic colorectal cancer, addition of cetuximab to second-line chemotherapy increased PFS.
[12]	Scope A, Agero ALC, Dusza SW et al. Randomized double-blind trial of prophylactic oral minocycline and topical tazarotene for cetuximab-associated acne-like eruption. J. Clin. Oncol. 25 (34), 5390–5396 (2007).
[13]	Bouché O, Ben Abdelghani M, Labourey J-L et al. Management of skin toxicities during panitumumab treatment in metastatic colorectal cancer. World J. Gastroenterol. 25 (29), 4007–4018 (2019).
[14]	Petrelli F, Ardito R, Ghidini A et al. Different toxicity of cetuximab and panitumumab in metastatic colorectal cancer treatment: a systematic review and meta-analysis. Oncology. 94 (4), 191–199 (2018).
[15]	Chen K-H, Shao Y-Y, Chen H-M et al. Primary tumor site is a useful predictor of cetuximab efficacy in the third-line or salvage treatment of KRAS wild-type (exon 2 non-mutant) metastatic colorectal cancer: A nationwide cohort study. BMC Cancer. 16, 327 (2016). Left-sided primary tumor site is a useful predictor of improved efficacy of cetuximab in third-line or salvage treatment of KRAS wild-type metastatic colorectal cancer.
[16]	Siegel RL, Miller KD, Goding Sauer A et al. Colorectal cancer statistics, 2020 CA. Cancer J. Clin. 70 (3), 145–164 (2020).
[17]	Iwamoto S, Hazama S, Kato T et al. Multicenter phase II study of second-line cetuximab plus folinic acid/5-fluorouracil/irinotecan (FOLFIRI) in KRAS wild-type metastatic colorectal cancer: the FLIER study. Anticancer Res. 34 (4), 1967–1973 (2014).
[18]	Yang YF, Wang GY, He JL, Wu FP, Zhang YN. Overall survival of patients with KRAS wild-type tumor treated with FOLFOX/FORFIRI±cetuximab as the first-line treatment for metastatic colorectal cancer: A meta-analysis. Medicine (Baltimore). 96 (12), e6335 (2017).
[19]	Sotelo MJ, García-Paredes B, Aguado C, Sastre J, Díaz-Rubio E. Role of cetuximab in first-line treatment of metastatic colorectal cancer. World J Gastroenterol. 20 (15), 4208–4219 (2014). Adding cetuximab to standard chemotherapy increases the response rate in patients with wild-type KRAS and can thus increase the resectability rate for liver metastases.
[20]	Aljehani MA, Morgan JW, Guthrie LA et al. Association of primary tumor site with mortality in patients receiving bevacizumab and cetuximab for metastatic colorectal cancer. JAMA Surg. 153 (1), 60–67 (2018).
[21]	Liu Y, Wang F, Ma N et al. Continued cetuximab in second-line treatment for patients with unresectable metastatic wild-type KRAS, NRAS, and BRAF colorectal cancer after disease progression during first-line cetuximab-based therapy. J. Clin. Oncol. Abstract 127 (2020).

Cite This Article

Plain Text BibTeX RIS

APA Style

Kayra Sánchez-Muñoz, José Pinto-Llerena. (2022). Anti-EGFR–Based Treatment of Patients with Metastatic Colorectal Cancer: Data from the National Oncology Institute of Panama. International Journal of Clinical Oncology and Cancer Research, 7(2), 35-40. https://doi.org/10.11648/j.ijcocr.20220702.14

Copy | Download

ACS Style

Kayra Sánchez-Muñoz; José Pinto-Llerena. Anti-EGFR–Based Treatment of Patients with Metastatic Colorectal Cancer: Data from the National Oncology Institute of Panama. Int. J. Clin. Oncol. Cancer Res. 2022, 7(2), 35-40. doi: 10.11648/j.ijcocr.20220702.14

Copy | Download

AMA Style

Kayra Sánchez-Muñoz, José Pinto-Llerena. Anti-EGFR–Based Treatment of Patients with Metastatic Colorectal Cancer: Data from the National Oncology Institute of Panama. Int J Clin Oncol Cancer Res. 2022;7(2):35-40. doi: 10.11648/j.ijcocr.20220702.14

Copy | Download

@article{10.11648/j.ijcocr.20220702.14,
  author = {Kayra Sánchez-Muñoz and José Pinto-Llerena},
  title = {Anti-EGFR–Based Treatment of Patients with Metastatic Colorectal Cancer: Data from the National Oncology Institute of Panama},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {7},
  number = {2},
  pages = {35-40},
  doi = {10.11648/j.ijcocr.20220702.14},
  url = {https://doi.org/10.11648/j.ijcocr.20220702.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20220702.14},
  abstract = {Treatments directed against EGFR, such as anti-VEGF monoclonal antibodies (bevacizumab) and anti-EGFR cetuximab or panitumumab, improve clinical outcomes in terms of overall survival and disease-free survival when combined with first-line chemotherapy treatments for metastatic colon cancer. Aims. To determine the epidemiological, clinical, and survival-related variables associated with the treatment of KRAS wild-type metastatic colon cancer with anti-EGFR agents in our institution. Patients & methods. We performed a retrospective review of the electronic files of patients with KRAS wild-type metastatic colon cancer treated with cetuximab between 2014 and 2019. Results. 169 patients diagnosed with metastatic Colorectal Cancer RAS WT receiving anti-EGFR treatment. The median age was 65 years, with 54% male. 91% with ECOG 0 – 1. KRAS test was performed to 100% of patients. 70% had a tumor on the left side of the colon. Objective response was 4.8%. The median PFS was 3 months and median OS was 5 months. Only the use of combined schemes such as FOLFIRI with cetuximab and exposure to cetuximab in some lines of treatment were shown to be significant prognostic factors for PFS, compared with those who did not receive it. Rash G1-2 was the most common adverse event. Conclusions. the epidemiological and clinical characteristics of our patients are like the world literature, however, the PFS and OS reached are lower than expected as well as adverse events registered. Most of the patients received anti-EGFR treatment in second line. These results allowed us to propose anti-EGFR treatment in colorectal cancer from the front line at the National Oncology Institute.},
 year = {2022}
}

Copy | Download

TY - JOUR
T1 - Anti-EGFR–Based Treatment of Patients with Metastatic Colorectal Cancer: Data from the National Oncology Institute of Panama
AU - Kayra Sánchez-Muñoz
AU - José Pinto-Llerena
Y1 - 2022/05/12
PY - 2022
N1 - https://doi.org/10.11648/j.ijcocr.20220702.14
DO - 10.11648/j.ijcocr.20220702.14
T2 - International Journal of Clinical Oncology and Cancer Research
JF - International Journal of Clinical Oncology and Cancer Research
JO - International Journal of Clinical Oncology and Cancer Research
SP - 35
EP - 40
PB - Science Publishing Group
SN - 2578-9511
UR - https://doi.org/10.11648/j.ijcocr.20220702.14
AB - Treatments directed against EGFR, such as anti-VEGF monoclonal antibodies (bevacizumab) and anti-EGFR cetuximab or panitumumab, improve clinical outcomes in terms of overall survival and disease-free survival when combined with first-line chemotherapy treatments for metastatic colon cancer. Aims. To determine the epidemiological, clinical, and survival-related variables associated with the treatment of KRAS wild-type metastatic colon cancer with anti-EGFR agents in our institution. Patients & methods. We performed a retrospective review of the electronic files of patients with KRAS wild-type metastatic colon cancer treated with cetuximab between 2014 and 2019. Results. 169 patients diagnosed with metastatic Colorectal Cancer RAS WT receiving anti-EGFR treatment. The median age was 65 years, with 54% male. 91% with ECOG 0 – 1. KRAS test was performed to 100% of patients. 70% had a tumor on the left side of the colon. Objective response was 4.8%. The median PFS was 3 months and median OS was 5 months. Only the use of combined schemes such as FOLFIRI with cetuximab and exposure to cetuximab in some lines of treatment were shown to be significant prognostic factors for PFS, compared with those who did not receive it. Rash G1-2 was the most common adverse event. Conclusions. the epidemiological and clinical characteristics of our patients are like the world literature, however, the PFS and OS reached are lower than expected as well as adverse events registered. Most of the patients received anti-EGFR treatment in second line. These results allowed us to propose anti-EGFR treatment in colorectal cancer from the front line at the National Oncology Institute.
VL - 7
IS - 2
ER -

Copy | Download

Author Information

Kayra Sánchez-Muñoz
José Pinto-Llerena

Gastrointestinal Tumors Unit, Medical Oncology Service, National Oncology Institute of Panama, Panama City, Panama

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Kayra Sánchez-Muñoz, José Pinto-Llerena. (2022). Anti-EGFR–Based Treatment of Patients with Metastatic Colorectal Cancer: Data from the National Oncology Institute of Panama. International Journal of Clinical Oncology and Cancer Research, 7(2), 35-40. https://doi.org/10.11648/j.ijcocr.20220702.14

Copy | Download

ACS Style

Kayra Sánchez-Muñoz; José Pinto-Llerena. Anti-EGFR–Based Treatment of Patients with Metastatic Colorectal Cancer: Data from the National Oncology Institute of Panama. Int. J. Clin. Oncol. Cancer Res. 2022, 7(2), 35-40. doi: 10.11648/j.ijcocr.20220702.14

Copy | Download

AMA Style

Kayra Sánchez-Muñoz, José Pinto-Llerena. Anti-EGFR–Based Treatment of Patients with Metastatic Colorectal Cancer: Data from the National Oncology Institute of Panama. Int J Clin Oncol Cancer Res. 2022;7(2):35-40. doi: 10.11648/j.ijcocr.20220702.14

Copy | Download

@article{10.11648/j.ijcocr.20220702.14,
  author = {Kayra Sánchez-Muñoz and José Pinto-Llerena},
  title = {Anti-EGFR–Based Treatment of Patients with Metastatic Colorectal Cancer: Data from the National Oncology Institute of Panama},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {7},
  number = {2},
  pages = {35-40},
  doi = {10.11648/j.ijcocr.20220702.14},
  url = {https://doi.org/10.11648/j.ijcocr.20220702.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20220702.14},
  abstract = {Treatments directed against EGFR, such as anti-VEGF monoclonal antibodies (bevacizumab) and anti-EGFR cetuximab or panitumumab, improve clinical outcomes in terms of overall survival and disease-free survival when combined with first-line chemotherapy treatments for metastatic colon cancer. Aims. To determine the epidemiological, clinical, and survival-related variables associated with the treatment of KRAS wild-type metastatic colon cancer with anti-EGFR agents in our institution. Patients & methods. We performed a retrospective review of the electronic files of patients with KRAS wild-type metastatic colon cancer treated with cetuximab between 2014 and 2019. Results. 169 patients diagnosed with metastatic Colorectal Cancer RAS WT receiving anti-EGFR treatment. The median age was 65 years, with 54% male. 91% with ECOG 0 – 1. KRAS test was performed to 100% of patients. 70% had a tumor on the left side of the colon. Objective response was 4.8%. The median PFS was 3 months and median OS was 5 months. Only the use of combined schemes such as FOLFIRI with cetuximab and exposure to cetuximab in some lines of treatment were shown to be significant prognostic factors for PFS, compared with those who did not receive it. Rash G1-2 was the most common adverse event. Conclusions. the epidemiological and clinical characteristics of our patients are like the world literature, however, the PFS and OS reached are lower than expected as well as adverse events registered. Most of the patients received anti-EGFR treatment in second line. These results allowed us to propose anti-EGFR treatment in colorectal cancer from the front line at the National Oncology Institute.},
 year = {2022}
}

Copy | Download