Background Cetuximab is a recombinant human/mouse chimeric monoclonal antibody that binds specifically to the extracellular domain of the human epidermal growth factor receptor (EGFR). It is indicated for the treatment of patients with EGFR-expressing, KRAS wild-type metastatic colorectal cancer.
Purpose To evaluate the use of cetuximab in patients with advanced or metastatic colorectal cancer, in a general hospital and to study the evolution of cancer marker levels involved, what causes treatment cesssation and toxicity associated with it.
Materials and methods Retrospective observational study in which we reviewed the medical records of patients treated with cetuximab in an oncology day hospital from January 2012 to January 2013. For the study, the data collected was: age, sex, number of episodes, line of treatment, chemotherapy regimen used, levels of tumour marker CA 19.9, causes of treatment cessation and toxicity. All the data was taken from the medical records and the Dominion patient management program. We also assessed cetuximab in a neo-adjuvant setting.
Results 22 patients with KRAS wild-type metastatic colorectal carcinoma were included in the study, 14 men (64%) and 8 women (36%). The median age was 65. In 64% (14) patients, cetuximab was used first line: FOLFOX (12) or FOLFIRI (2) and in 42% (8) was used in second or successive lines with different schemes: FOLFOX (4), XELOX (2), TOMOX (1), FOLFIRI (1). In all cases the dose was 500 mg/m2. The cause of the end of treatment, for 26% (5) of the patients, was disease progression, toxicity in 37% (7) of the cases, of which 18% was cutaneous toxicity; neo-adjuvant surgery in 21% (4) cases and stabilisation 16% (3). The median number of cycles received was 8.5. Within the patients treated in first line in whom we observed disease progression, the median progression-free survival was 10 months.
The treatment was never pursued if an increase in levels of tumour marker Ca 19.9 was observed.
Conclusions The efficacy findings from our study are consistent with other published literature (CRYSTAL, OPUS).
Chemotherapy treatment protocols used were in line with cetuximab’s European Public Assessment Report in 72% of cases.
The addition of cetuximab seems to offer a chance to further enhance the activity of conventional chemotherapy. Nevertheless the treatment is also tending to get more complicated, emphasising the need for an assessment.
No conflict of interest.
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