Pietrantonio Filippo, Perrone Federica, Biondani Pamela, Maggi Claudia, Lampis Andrea, Bertan Claudia, Venturini Filippo, Tondulli Luca, Ferrari Daris, Ricci Vincenzo, Villa Federica, Barone Gloria, Bianco Nadia, Ghidini Antonio, Bossi Ilaria, Fanetti Giuseppe, Di Bartolomeo Maria, de Braud Filippo
Medical Oncology Department; Fondazione I.R.C.C.S. Istituto Nazionale Tumori; Milan, Italy.
Department of Pathology; Fondazione I.R.C.C.S. Istituto Nazionale Tumori; Milan, Italy.
Cancer Biol Ther. 2013 Dec;14(12):1098-103. doi: 10.4161/cbt.26343. Epub 2013 Sep 4.
Few data are available outlining outcomes of panitumumab in advanced colorectal cancer patients benefiting from prior cetuximab-based regimens.
Thirty patients with KRAS wild type metastatic colorectal cancer with clinical benefit from prior cetuximab-based regimens between May 2004 and October 2011 were reviewed at nine Italian Institutions. Inclusion key criteria included interruption of cetuximab for reasons other than progressive disease. Patients were classified according to prior regimens (0 or ≥1), prior response or stabilization, surgery of metastases, and Köhne prognostic score. At the time of subsequent progression, patients were treated with single agent panitumumab until progressive disease, unacceptable toxicity, or consent withdrawal.
Panitumumab obtained 67% disease control rate and 30% objective response rate, with median PFS of 4.2 and median OS of 9.6 mo. Patients with BRAF/NRAS/PI3KCA and KRAS (by mutant enriched technique) wild-type tumors had the best chance of response to panitumumab.
Single agent panitumumab provided significant clinical benefit in heavily pretreated patients without acquired resistance to prior cetuximab-based regimens.
关于帕尼单抗在从基于西妥昔单抗的既往治疗方案中获益的晚期结直肠癌患者中的疗效数据较少。
对2004年5月至2011年10月期间在意大利9家机构接受治疗的30例KRAS野生型转移性结直肠癌患者进行回顾,这些患者从基于西妥昔单抗的既往治疗方案中获得了临床益处。纳入的关键标准包括因疾病进展以外的原因中断西妥昔单抗治疗。根据既往治疗方案(0种或≥1种)、既往反应或病情稳定情况、转移灶手术情况以及Köhne预后评分对患者进行分类。在后续疾病进展时,患者接受单药帕尼单抗治疗,直至疾病进展、出现不可接受的毒性反应或患者撤回同意书。
帕尼单抗的疾病控制率为67%,客观缓解率为30%,中位无进展生存期为4.2个月,中位总生存期为9.6个月。BRAF/NRAS/PI3KCA和KRAS(通过突变富集技术检测)野生型肿瘤患者对帕尼单抗的反应机会最大。
单药帕尼单抗在既往未对基于西妥昔单抗的治疗方案产生获得性耐药的经大量预处理的患者中提供了显著的临床益处。