Phase II Trial of Cetuximab in Combination With Fluorouracil, Leucovorin, and Oxaliplatin in the First-Line Treatment of Metastatic Colorectal Cancer

Abstract

Cetuximab in combination with FOLFOX-4 is a highly active first-line treatment for mCRC, showing encouraging RR, mPFS, and mOS values. The treatment resulted in a high resectability rate, which could potentially result in an improved cure rate. This combination is under phase III development.

Cetuximab Plus FOLFIRINOX (ERBIRINOX) as First-Line Treatment for Unresectable Metastatic Colorectal Cancer: A Phase II Trial

“…The results of this first phase II study evaluating the ERBIRINOX regimen in patients with unresectable mCRC demonstrate that this combination is both feasible and effective. The complete response rate of 11.9% seems to be interesting, compared with previous results with cetuximab plus doublet chemotherapy [13][14][15][16][17][18] or FOLFIRINOX alone [7,9,10]. This is comparable with the CR rate reported with bevacizumab plus FOLFOXIRI combination therapy [19].…”

“…This allowed a favorable outcome in most cases, leading us to recommend these practices in future studies using the same regimen. Grade 3-4 neutropenia was reported at similar levels in all studies testing cetuximab plus FOLFIRI or FOLFOX and FOLFIRINOX alone [7,9,10,[13][14][15], provided that prophylactic G-CSF is given with ERBIRI-NOX. In total, only four patients in our study needed to stop the treatment prematurely as a result of toxicity, although a large proportion of patients (76%) had at least one dose reduction.…”

C20orf20 (MRG-binding protein) as a potential therapeutic target for colorectal cancer

“…In chemotherapies for advanced colorectal cancer, oxaliplatin/fluorouracil/leucovorin (FOLFOX) is an effective and well-tolerated regimen. Combination of targeted biological agents such as anti-epidermal growth factor receptor (EGFR) with FOLFOX have been reported to enhance the efficacy against EGFRexpressing metastatic colorectal cancer (Giantonio, 2006;Tabernero et al, 2007). This indicates that the use of rationally selected therapeutic agents will improve the treatment for advanced diseases and results in increase of cure rate and/or prolonged survival.…”

Monoclonal antibodies for the treatment of non-haematological tumours: update of an expanding scenario

“…Moreover, the presence of BRAF V600E mutation conferred a poorer prognosis in both the arms [56][57][58]. The positive results in terms of PFS of the combination of cetuximab with oxaliplatin-based chemotherapy in the OPUS trial, in KRAS wild-type patients, led to the approval of cetuximab as firstline treatment in EGFR-expressing and KRAS wild-type mCRC patients [59]. In contrast to these data, both in the COIN and the Nordic FLOX trial the addition of cetuximab to either FOLFOX/Capecitabine plus oxaliplatin (CAPOX) (MRC COIN) or oxaliplatin plus a fluoro-pyrimidine (FLOX) (NordicFLOX) did not demonstrate a significant improvement in either OS or PFS.…”