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DGI-071 The Rational Use of Cetuximab in Metastatic Colorectal Cancer
  1. E Puerta1,
  2. M Cañadas2,
  3. A Perez3,
  4. I Vallejo1,
  5. A Concha3,
  6. MA Calleja1
  1. 1Hospital Universitario Virgen de las Nieves, Pharmacy Service, Granada, Spain
  2. 2Hospital Universitario Virgen de las Nieves, Pharmacogenetics Unit, Granada, Spain
  3. 3Hospital Universitario Virgen de las Nieves, Phatology Deparment, Granada, Spain

Abstract

Background Cetuximab label indication includes treatment of epidermal growth factor receptor (EGFR)-expressing, KRAS wild-type metastatic colorectal cancer in several possible ways: combination with irinotecan-based chemotherapy, first-line in combination with FOLFOX and as a single agent after oxaliplatin- and irinotecan-based treatment failure in irinotecan-intolerant patients. In our hospital, a multidisciplinary team drawn from the Oncology and Pharmacy services has established a consensus for the rational use of cetuximab as first or second-line agent in association with other chemotherapeutic agents and as monotherapy in third-line treatment after the failure of oxaliplatin and irinotecan-based treatment.

Purpose To verify the relevance of cetuximab prescription to the local protocol and cheque the label indications for cetuximab in our hospital.

Materials and Methods A retrospective study of patients diagnosed with metastatic colorectal cancer between 2006–2012 with available KRAS status. Patients were followed up for a minimum of three months after diagnosis.

Results Twenty-six patients were collected (mean age: 62.2 ± 12.6 years; 53.8% male).

KRAS mutation was negative in 42.3% (11/26) patients and therefore they were eligible for treatment with cetuximab. Five out of those 11 patients underwent cetuximab treatment (5/11; 45.5%): three associated with oxaliplatin in first-line treatment, one associated with irinotecan in second-line treatment and one as monotherapy in second-line treatment. Four out of these 5 prescriptions of cetuximab were in accordance to our local protocol and label (4/5; 80.0%). One prescription was not in accordance with either the local protocol or the cetuximab label; due to this the patient was treated with oral capecitabine as first-line and cetuximab monotherapy as second-line treatment.

Three KRAS-negative patients (3/11; 27.3%) are currently in treatment with irinotecan as second-line therapy.

Three KRAS-negative patients were lost to follow-up after undergoing second-line treatment not known to contain a cetuximab prescription (3/11; 27.3%).

Fifteen patients positive for KRAS mutation (15/26; 57.7%) were not treated with cetuximab.

Conclusions Ninety-five percent of cetuximab prescriptions in our hospital are in accordance with the established local protocol and the cetuximab label (19/20).

No conflict of interest.

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