Assessment of Baseline Clinical Predictive Factors of Response to Cetuximab-Irinotecan in Patients with Irinotecan-Refractory Metastatic Colorectal Cancer

Abstract

Objective: To identify easily available predictive factors of response to cetuximab-irinotecan in patients with irinotecan-refractory metastatic colorectal cancer. Methods: Retrospective analysis of patients treated with cetuximab (400 mg/m² in week 1, 250 mg/m² in subsequent weeks) plus irinotecan (180 mg/m² every 2 weeks). We assessed demographic data, prior response to chemotherapy, number of metastatic sites, disease and metastatic disease durations, irinotecan-free interval and tumoral immunohistochemical epidermal growth factor receptor status. Results: We analyzed 311 patients. Objective response rate under cetuximab-irinotecan was 26%. In univariate analysis, prior response to irinotecan, presence of only 1 metastatic site, disease duration, metastatic disease duration and irinotecan-free interval equal or above median (24, 18 and 1.8 months, respectively) were predictive of response to cetuximab-irinotecan. Multivariate analysis confirmed independent predictive value of prior response to irinotecan, number of metastatic sites and disease duration. Conclusion: Prior response to irinotecan, number of metastatic sites and disease duration may contribute to better select patients suitable for cetuximab-irinotecan therapy.

A real-world analysis of nanoliposomal-irinotecan with 5-fluorouracil and folinic acid as third- or later-line therapy in patients with metastatic pancreatic adenocarcinoma

“…The irinotecan-free interval is also available potential predictive factors. 21 , 22 And a correlation between irinotecan-free interval and survival outcomes was observed in the current study. Further investigation such as prospective, comparative cohort study is needed to clarify these prognostic factors.…”

Biweekly cetuximab plus irinotecan as second-line chemotherapy for patients with irinotecan-refractory and KRAS wild-type metastatic colorectal cancer according to epidermal growth factor receptor expression status

“…Other retrospective studies found that EGFR expression was not associated with the efficacy of cetuximab [22] or panitumumab, another anti-EGFR monoclonal antibody [23]. Moreover, a recent prospective study found that cetuximab monotherapy was as effective in mCRC patients negative for EGFR as in those with EGFR IHC-positive disease, although patients were not selected based on KRAS mutation status in this previous study [24].…”

Fibroblast growth factor receptor 4 increases epidermal growth factor receptor (EGFR) signaling by inducing amphiregulin expression and attenuates response to EGFR inhibitors in colon cancer

“…As reported in several clinical trials, EGFR status is not a reliable biomarker to select patients for cetuximab-based therapy. [43][44][45] KRAS, NRAS, and BRAF status are F I G U R E 6 Fibroblast growth factor receptor 4 (FGFR4) increases cell viability against epidermal growth factor receptor inhibition in colon cancer cells. A, Colon cancer cells with FGFR4 expression or vector control plasmid were treated with different concentrations of cetuximab (range, 31-500 μg/mL) for 48 h and cell viability were evaluated.…”