Effect of Oxaliplatin, Fluorouracil, and Leucovorin With or Without Cetuximab on Survival Among Patients With Resected Stage III Colon Cancer

Abstract

III colon cancer have a 50% chance of cure with surgery. 1 Multiple trials have established the benefit of adjuvant chemotherapy in reducing the recurrence risk. Specifically, leucovorin, fluorouracil, and oxaliplatin (FOLFOX or slightly different method, FLOX) provides significant benefit in both disease-free and overall survival compared with the prior standard of fluorouracil and leucovorin. [2][3][4] In the setting of metastatic colorectal cancer, cetuximab and panitumumab are US Food and Drug Administration approved for targeting the For editorial comment see p 1431.

Combination therapy with zoledronic acid and cetuximab effectively suppresses growth of colorectal cancer cells regardless of KRAS status

“…Despite recent advances in the development of various diagnostic tools, in many patients, colorectal cancer is still diagnosed at an advanced stage, and recurrent tumors are often detected even after curative surgery. On the other hand, new chemotherapeutic regimens such as FOLFOX, FOLFIRI, and XELOX have been developed to exert a more potent activity 3, 4, 5, 6. More recently, molecular targeted therapies such as tyrosine kinase inhibitors and monoclonal antibodies have been shown to enhance tumor regression in combination with chemotherapy 7, 8…”

Standard chemotherapy with cetuximab for treatment of colorectal cancer

“…A total of eight RCTs [17,[21][22][23][24][25][26][27] were included for this metaanalysis involving a number of 6780 mCRC patients. Among these eligible trials, full articles are available from databases.…”

“…Five of them [17,22,[25][26][27] assessed oxaliplatin based chemotherapy regimen plus cetuximab in the firstline treatment of metastatic or advanced CRC, while two studies [21,24] evaluated the effect of cetuximab in combination with the FOLFIRI regimen on outcome of metastatic or advanced CRC patients, and only one trial [23] involved both FOLFIRI or oxaliplatin based regimen. All studies [17,[21][22][23][24][25][26] reported the status of KRAS in mCRC except the study of Borner et al [27] . Data from these RCTs were sufficient to support the statistically pooled analysis of PFS and OS.…”

“…To evaluate whether cetuximab plus chemotherapy could benefit OS in population harboring wild-type KRAS, seven studies were included [17,[21][22][23][24][25][26] . As shown in Figure 3, though cetuximab plus chemotherapy seemed to provide a benefit in prolonging OS, there was no statistically significance (HR = 0.95, 95%CI: 0.86-1.05; P > 0.05).…”

“…A significant difference was not observed from the pooled analysis (HR = 1.10, 95%CI: 0.94-1.28; P > 0.05; Figure 3). [22] Full manuscript 571 Cetuximab + FLOX FLOX PFS: NR; OS: NR Yes Yes Good Alberts et al [26] Full manuscript 2686 Cetuximab + mFOLFOX6 mFOLFOX6 PFS: NR; OS: NR Yes Yes Good Huang et al [24] Full Li XX et al . Efficacy of cetuximab and KRAS status…”