Service d'Oncologie Médicale, Oncology Unit, Hopital Paul Brousse, 12 avenue Paul Vaillant Couturier, 94800 Villejuif, France.
Med Oncol. 2011 Dec;28 Suppl 1:S253-8. doi: 10.1007/s12032-010-9716-8. Epub 2010 Nov 5.
Cetuximab was approved using a weekly schedule, alone or in combination with chemotherapy (CT). However, many CT regimens in metastatic colorectal cancer (CRC) are delivered every 2 weeks (q2wks). Preliminary data suggested that a simplified schedule using cetuximab q2wks, 500 mg/m² would be equivalent to the standard weekly administration. Medical data of all patients with advanced CRC who received cetuximab q2wks were retrospectively collected and checked for consistency by an independent monitor in 4 European centers. Ninety-one patients were treated between 2005 and 2007 when the K-RAS mutational status of tumors was not determined routinely. They received a median of 4 (0-5) previous drugs, including previous weekly cetuximab in 38.5% of patients. Cetuximab q2wks was associated with an irinotecan-based regimen in 85.7% of patients. The median number of cetuximab administrations was 6 (1-23). Skin toxicity was observed in 68.2% of evaluable patients (grade 3 in 15%). Only one grade 1 allergy was reported. In the 84 patients beyond first-line therapy, response rate was 29.3%. The median progression-free survival was 3.0 months (range 2.2-3.8), and median overall survival was 9.0 months (range 6.2-11.8). Cetuximab q2wks appears safe and effective in heavily pretreated patients and convenient in combination with q2wks CT schedules.
西妥昔单抗最初是按每周方案批准使用的,单独使用或与化疗(CT)联合使用。然而,转移性结直肠癌(CRC)中的许多 CT 方案每 2 周(q2wks)给药一次。初步数据表明,使用每 2 周(q2wks)、500mg/m²的简化方案给予西妥昔单抗,其疗效与标准每周给药方案相当。在 4 个欧洲中心,回顾性收集了所有接受西妥昔单抗 q2wks 治疗的晚期 CRC 患者的医疗数据,并由独立监测员进行一致性检查。91 例患者于 2005 年至 2007 年期间接受治疗,当时肿瘤的 K-RAS 突变状态未常规确定。他们接受了中位数为 4(0-5)种先前的药物治疗,包括 38.5%的患者接受了先前的每周西妥昔单抗治疗。85.7%的患者接受了基于伊立替康的方案联合西妥昔单抗 q2wks 治疗。西妥昔单抗 q2wks 的中位给药次数为 6(1-23)次。可评价患者中 68.2%(15%为 3 级)观察到皮肤毒性。仅报告了 1 例 1 级过敏反应。在 84 例一线治疗后患者中,缓解率为 29.3%。中位无进展生存期为 3.0 个月(范围 2.2-3.8),中位总生存期为 9.0 个月(范围 6.2-11.8)。西妥昔单抗 q2wks 治疗方案在接受大量预处理的患者中安全且有效,并且与 q2wks CT 方案联合应用非常方便。