Safety and efficacy of biweekly cetuximab based chemotherapy for patients with metastatic colorectal cancer

Abstract

How to cite this article: Zekri J, Farag K, Al-Saadi R, Ashour M, Haggag R. Safety and efficacy of biweekly cetuximabbased chemotherapy for patients with metastatic colorectal cancer. J Unexplored Med Data 2016;1:15-20. Aim:Cetuximab was administered weekly in registration clinical trials. Biweekly administration is more convenient when combining cetuximab with biweekly chemotherapy in patients with metastatic colorectal cancer (mCRC). The aim of this study is to evaluate safety and efficacy of biweekly cetuximab at a dose of 500 mg/m 2 with chemotherapy in routine clinical practice. Methods: Clinical data of 19 consecutive patients with K-RAS wild type mCRC who received biweekly cetuximab with biweekly fluropyrimidine based chemotherapy were reviewed. Toxicity assessment was limited to the first 6 cycles of treatment. Best tumor response was assessed by an independent radiologist. Results: Median age was 59 (24-74) years. Cetuximab was administered in first, second and third line settings in 7, 9 and 3 patients respectively. Grade I/II cetuximab specific adverse events (AEs) were skin rash (47.3%), diarrhea (21%), infusion reactions (10.5%), Hypomagnesaemia (10.5%) and nail disorders (5%). Grade III AEs were skin rash (10.5%) and diarrhea (5.3%). There was no grade IV AEs. There were no complete responders. Partial response was achieved in 8 (42.1%) and stable disease in 6 (31.5%) patients. Conclusion: This small but real life experience shows that biweekly cetuximab with chemotherapy is safe and effective. The frequency of AEs compares favorably to weekly administration reported in the literature. These finding add to the relatively limited available data on biweekly administration to support its adoption in routine clinical practice. ABSTRACT

Real-world comparison between weekly versus biweekly dosing of cetuximab for metastatic colorectal cancer

“…The robustness of the findings was confirmed by a battery of sensitivity analyses, and this is a strength of the present study. The findings of the present study are supported by existing pharmacokinetic, pharmacodynamics and clinical data on the efficacy and tolerability of 500 mg/m 2 biweekly cetuximab for patients with mCRC in first and subsequent lines of treatment [ 37 , 38 ].…”

Nursing care and management of adverse events for patients with BRAFV600E-mutant metastatic colorectal cancer receiving encorafenib in combination with cetuximab: a review

“…Weekly infusions mean frequent visits to the hospital for patients, perpetuating treatment fatigue. Consequently, some centres administer cetuximab bi-weekly, which is more convenient for both the patient and treating institution [ 25 – 27 ]. Available data suggest bi-weekly cetuximab, at 500 mg/m 2 , has an equivalent pharmacokinetic, efficacy and safety profile to weekly administration.…”

“…Available data suggest bi-weekly cetuximab, at 500 mg/m 2 , has an equivalent pharmacokinetic, efficacy and safety profile to weekly administration. However, these results come from patients treated with cetuximab alongside chemotherapy and not encorafenib, so further data are needed to confirm the efficacy of bi-weekly cetuximab in this setting [ 25 – 27 ].…”