First-line single-agent panitumumab in frail elderly patients with wild-type KRAS metastatic colorectal cancer and poor prognostic factors: A phase II study of the Spanish Cooperative Group for the Treatment of Digestive Tumours

Sastre, Javier; Massutí, Bartomeu; Pulido, G.; Guillén‐Ponce, Carmen; Benavides, Manuel; Manzano, José Luís; Reboredo, Margarita; Rivera, Fernando; Grávalos, Cristina; Safont, María José; Villacampa, M. Martinez; Llovet, Patricia; Dotor, E.; Dı́az-Rubio, Eduardo; Aranda, Enrique

doi:10.1016/j.ejca.2015.04.013

Cited by 48 publications

(37 citation statements)

References 36 publications

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“…However, the most important limitations in the existing literature regarding chemotherapy and fragility are the retrospective nature of these studies, small sample size, and lack of power to determine clinically relevant changes . Table summarizes the characteristics of some of the important frailty studies that have reported outcome data other than surgery …”

Section: Frailty and Chemotherapymentioning

confidence: 99%

“…Those authors reported a median progression‐free survival of 4.3 months and a median OS of 7.1 months. There were no deaths or grade 4 or 5 adverse events related to panitumumab, leading the authors to suggest that single‐agent panitumumab may be a therapeutic option for high‐risk, frail elderly patients who are not considered candidates for chemotherapy …”

Section: Frailty and Chemotherapymentioning

confidence: 99%

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Frailty and cancer: Implications for oncology surgery, medical oncology, and radiation oncology

Ethun

Bilen

Jani

et al. 2017

CA A Cancer J Clinicians

456

324

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https://www.wileyhealthlearning.com/acs.aspx The concept of frailty has become increasingly recognized as one of the most important issues in health care and health outcomes and is of particular importance in patients with cancer who are receiving treatment with surgery, chemotherapy, and radiotherapy. Because both cancer itself, as well as the therapies offered, can be significant additional stressors that challenge a patient's physiologic reserve, the incidence of frailty in older patients with cancer is especially high—it is estimated that over one‐half of older patients with cancer have frailty or prefrailty. Defining frailty can be challenging, however. Put simply, frailty is a state of extreme vulnerability to stressors that leads to adverse health outcomes. In reality, frailty is a complex, multidimensional, and cyclical state of diminished physiologic reserve that results in decreased resiliency and adaptive capacity and increased vulnerability to stressors. In addition, over 70 different measures of frailty have been proposed. Still, it has been demonstrated that frail patients are at increased risk of postoperative complications, chemotherapy intolerance, disease progression, and death. Although international standardization of frailty cutoff points are needed, continued efforts by oncology physicians and surgeons to identify frailty and promote multidisciplinary decision making will help to develop more individualized management strategies and optimize care for patients with cancer. CA Cancer J Clin 2017;67:362–377. © 2017 American Cancer Society.

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Section: Frailty and Chemotherapymentioning

confidence: 99%

Section: Frailty and Chemotherapymentioning

confidence: 99%

Frailty and cancer: Implications for oncology surgery, medical oncology, and radiation oncology

Ethun

Bilen

Jani

et al. 2017

CA A Cancer J Clinicians

456

324

View full text Add to dashboard Cite

show abstract

“…The randomized phase II PEAK trial showed that mFOLFOX6 with panitumumab resulted in longer OS compared with mFOLFOX6 with bevacizumab as first-line treatment in patients with unresectable WT KRAS exon 2 mCRC [37]. A single-arm, phase II trial demonstrated that panitumumab monotherapy may also be a treatment option for the ‘frail elderly’, who are unable to receive chemotherapy [38]. In 33 patients with a mean age of 81 years who were unfit for chemotherapy, monotherapy with panitumumab resulted in a median PFS of 4.3 months and OS of 7.1 months.…”

Section: Efficacymentioning

confidence: 99%

Clinical Pharmacokinetics and Pharmacodynamics of the Epidermal Growth Factor Receptor Inhibitor Panitumumab in the Treatment of Colorectal Cancer

et al. 2017

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Despite progress in the treatment of metastatic colorectal cancer (mCRC) in the last 15 years, it is still a condition with a relatively low 5-year survival rate. Panitumumab, a fully human monoclonal antibody directed against the epidermal growth factor receptor (EGFR), is able to prolong survival in patients with mCRC. Panitumumab is used in different lines of therapy in combination with chemotherapy, and as monotherapy for the treatment of wild-type (WT) RAS mCRC. It is administered as an intravenous infusion of 6 mg/kg every 2 weeks and has a t ½ of approximately 7.5 days. Elimination takes place via two different mechanisms, and immunogenicity rates are low. Only RAS mutations have been confirmed as a negative predictor of efficacy with anti-EGFR antibodies. Panitumumab is generally well tolerated and has a manageable toxicity profile, despite a very high prevalence of dermatologic side effects. This article presents an overview of the clinical pharmacokinetics and pharmacodynamics of panitumumab, including a description of the studies that led to its approval in the different lines of therapy of mCRC.

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“…Furthermore, a pilot study of firstline panitumumab monotherapy has shown the activity and tolerability of treatment in frail elderly patients with gastrointestinal cancer classified as Köhne intermediate or high risk. 25 The treatment guidelines issued by the European Society of Medical Oncology in 2016 recommend that the aim of treatment should be considered in management decisions for patients with mCRC. 1 The guidelines broadly define 2 patient categories: those with potentially resectable disease or who need a rapid reduction in tumor symptoms, for whom cytoreduction is the primary aim of treatment, and those for whom the aim is disease control and aggressive treatment is not necessary.…”

Section: Discussionmentioning

confidence: 99%

Survival Outcomes in Patients With RAS Wild Type Metastatic Colorectal Cancer Classified According to Köhne Prognostic Category and BRAF Mutation Status

Siena

Rivera

Taı̈eb

et al. 2018

Clinical Colorectal Cancer

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First-line single-agent panitumumab in frail elderly patients with wild-type KRAS metastatic colorectal cancer and poor prognostic factors: A phase II study of the Spanish Cooperative Group for the Treatment of Digestive Tumours

Cited by 48 publications

References 36 publications

Frailty and cancer: Implications for oncology surgery, medical oncology, and radiation oncology

Frailty and cancer: Implications for oncology surgery, medical oncology, and radiation oncology

Clinical Pharmacokinetics and Pharmacodynamics of the Epidermal Growth Factor Receptor Inhibitor Panitumumab in the Treatment of Colorectal Cancer

Survival Outcomes in Patients With RAS Wild Type Metastatic Colorectal Cancer Classified According to Köhne Prognostic Category and BRAF Mutation Status

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