Cetuximab in refractory metastatic colorectal cancer: Analysis of efficacy and response by patient and disease variables

Mirtsching, B.; Cichoń, Justyna; Beasley, Stephen; Teel, Cynthia; Jackson, DL; Headlee, Cecil P.

doi:10.1200/jco.2005.23.16_suppl.3671

Cited by 8 publications

(12 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the six citations identified, one was an RCT, 73 one was a single-arm study of cetuximab monotherapy 74 and four were abstracts [75][76][77][78] presented at ASCO general meetings. With the exception of data from the MABEL study, 72 all trial data were derived from sources in the public domain.…”

Section: Number and Type Of Studies Includedmentioning

confidence: 99%

Systematic review and economic evaluation of bevacizumab and cetuximab for the treatment of metastatic colorectal cancer

Tappenden

Jones²,

Paisley³

et al. 2007

Health Technol Assess

118

View full text Add to dashboard Cite

The trials indicate that bevacizumab in combination with 5-FU/FA, and bevacizumab in combination with IFL, is clinically effective in comparison to standard chemotherapy options for the first-line treatment of metastatic CRC. The health economic analysis suggests that the marginal cost-utility of bevacizumab plus IFL versus IFL is unlikely to be better than pound 62,857 per QALY gained, and the marginal cost-utility of bevacizumab plus 5-FU/FA versus 5-FU/FA is unlikely to be better than pound 88,658 per QALY gained. There is no direct evidence to demonstrate whether cetuximab in combination with irinotecan improves health-related quality of life or OS in comparison to active/best supportive care or oxaliplatin plus 5-FU/FA, although the evidence on tumour response rates suggests that cetuximab plus irinotecan has some clinical activity. While it is difficult to suggest whether cetuximab represents value for money, indirect comparisons suggest that the incremental cost-utility of cetuximab plus irinotecan is unlikely to be better than pound 30,000 per QALY gained. This review highlights a number of areas for further research, including clarifying the true impact of first-line bevacizumab in combination with irinotecan and/or infusional 5-FU/FA, without subsequent bevacizumab treatment following disease progression, on OS in patients with metastatic CRC who are representative of the typical population of CRC patients in England and Wales. Further research concerning the impact of therapies on health-related quality of life is essential.

show abstract

Section: Number and Type Of Studies Includedmentioning

confidence: 99%

Systematic review and economic evaluation of bevacizumab and cetuximab for the treatment of metastatic colorectal cancer

Tappenden

Jones²,

Paisley³

et al. 2007

Health Technol Assess

118

View full text Add to dashboard Cite

show abstract

“…61 Response and survival time have been shown to be positively correlated with the severity of skin rash in phases II and III clinical studies. 13,14,[62][63][64] Retrospective analyses have reported similar findings. 27,65 The rationale for this correlation is unclear, but skin rash may be a surrogate indicator of an adequate degree of receptor saturation by EGFR inhibitors.…”

Section: Management Of Cetuximab-and Panitumumab-associated Adversementioning

confidence: 68%

Clinical Use of Anti‐Epidermal Growth Factor Receptor Monoclonal Antibodies in Metastatic Colorectal Cancer

Patel

2008

Pharmacotherapy

View full text Add to dashboard Cite

Cetuximab and panitumumab, monoclonal antibodies used to target the epidermal growth factor receptor (EGFR), were recently approved by the United States Food and Drug Administration for use as single agents or in combination with other chemotherapy drugs in the treatment of metastatic colorectal cancer. The anti-EGFR monoclonal antibodies, either as single agents or in combination with chemotherapy, have demonstrated clinical activity in this setting. When combined with standard cytotoxic chemotherapy or other targeted agents (e.g., bevacizumab, an anti-vascular endothelial growth factor monoclonal antibody), anti-EGFR monoclonal antibodies have been well tolerated and produced minimal toxicities. However, cetuximab and panitumumab appear to benefit only select patients. Predictive markers of efficacy, including EGFR overexpression, development of skin rash, and the absence of a K-ras mutation, have been evaluated in clinical studies to identify patients likely to respond to anti-EGFR monoclonal antibody therapy. This review discusses recent clinical studies of anti-EGFR monoclonal antibodies in the treatment of metastatic colorectal cancer, predictive markers of their efficacy, and common toxicities associated with their use.

show abstract

“…This is because cetuximab clinical trials were designed to include patients with EGFR-expressing disease in an attempt to avoid subjecting patients with non-EGFRexpressing tumors to what was at the time assumed to be inappropriate treatment. However, data from a number of clinical studies show no apparent correlation between the extent of EGFR expression and the response of tumors to cetuximab [24] or survival [83,84]. Moreover, patients with tumors undetectable for EGFR can achieve a response to cetuximab.…”

Section: The Value Of the Egfr As A Predictor Of Response To Egfr Inhmentioning

confidence: 96%

Targeted therapies for patients with advanced colorectal cancer: focus on cetuximab

Cutsem¹,

Labianca

Cognetti³

et al. 2006

Targ Oncol

View full text Add to dashboard Cite

Colorectal cancer (CRC) is the fourth most common cancer in men and the third in women worldwide. Combinations of 5-fluorouracil (5-FU)/folinic acid (FA) with irinotecan or oxaliplatin form the standard treatment approaches for metastatic disease. The introduction of targeted agents has presented the opportunity to improve on the efficacy of current treatments without exacerbating the associated toxicity. Cetuximab (Erbitux ® ) is an IgG1 monoclonal antibody (MAb) that specifically targets the epidermal growth factor receptor (EGFR) with high affinity and competitively inhibits endogenous ligand binding. Cetuximab has shown good efficacy in combination with irinotecan in CRC that had previously progressed on irinotecan-based therapy. Cetuximab plus irinotecan and various schedules of 5-FU/FA have shown efficacy in a first-line setting. The activity of cetuximab and oxaliplatinbased regimens is being investigated in both first-and subsequent-line settings. Cetuximab is well tolerated and does not increase the side effect profile of agents it is combined with. Other EGFR inhibitors, including the tyrosine kinase inhibitors, gefitinib and erlotinib, and the MAbs, panitumumab and matuzumab, are also being investigated in a number of solid tumors. The vascular endothelial growth factor (VEGF) inhibitor, bevacizumab, although apparently inactive as a single agent, has demonstrated survival benefits when combined with bolus 5-FU/ FA and irinotecan in a first-line setting and with 5-FU/FA and oxaliplatin in the second-line treatment of metastatic CRC. In this paper we discuss the use of targeted therapies in the treatment of metastatic CRC, with a focus on cetuximab.

show abstract

Cetuximab in refractory metastatic colorectal cancer: Analysis of efficacy and response by patient and disease variables

Cited by 8 publications

References 0 publications

Systematic review and economic evaluation of bevacizumab and cetuximab for the treatment of metastatic colorectal cancer

Systematic review and economic evaluation of bevacizumab and cetuximab for the treatment of metastatic colorectal cancer

Clinical Use of Anti‐Epidermal Growth Factor Receptor Monoclonal Antibodies in Metastatic Colorectal Cancer

Targeted therapies for patients with advanced colorectal cancer: focus on cetuximab

Contact Info

Product

Resources

About