Horie Yoshiki, Yamazaki Kentaro, Funakoshi Taro, Hamauchi Satoshi, Taniguchi Hiroya, Tsushima Takahiro, Todaka Akiko, Machida Nozomu, Taku Keisei, Fukutomi Akira, Onozawa Yusuke, Yasui Hirofumi, Mizukami Takuro, Izawa Naoki, Hirakawa Mami, Tsuda Takashi, Nakajima Takako, Boku Narikazu
Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Kanagawa 216-8511, Japan ; Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Shizuoka 411-8777, Japan.
Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Shizuoka 411-8777, Japan.
Mol Clin Oncol. 2015 Sep;3(5):1029-1034. doi: 10.3892/mco.2015.586. Epub 2015 Jun 24.
The efficacy of cetuximab correlates with the severity of skin toxicity, although its onset may vary. The AIM of this retrospective study was to investigate the optimal observation period for skin rash as a predictor of the efficacy of cetuximab plus irinotecan. The subjects comprised 33 patients with KRAS wild-type metastatic colorectal cancer (mCRC) who had received prior chemotherapy with fluorouracil, irinotecan and oxaliplatin. The response rate (RR), progression-free survival (PFS) and overall survival (OS) were compared according to the presence or absence of ≥grade 2 skin rash within 2, 4, 6, or 8 weeks following cetuximab initiation. The overall RR was 45% (15/33) and the median PFS and OS were 188 and 383 days, respectively. A total of 26 patients experienced ≥grade 2 skin rash within 8 weeks. The proportion of responders among patients who developed ≥grade 2 skin rash (severe group) decreased depending on the duration of the observation period (50% within 8 weeks), whereas the proportion of non-responders among patients with <grade 2 skin rash (mild group) increased (71% within 8 weeks). Similarly, the proportion of patients with an unfavorable prognosis (PFS <6 months, OS <1 year) in the mild group increased (86% for PFS and 71% for OS within 8 weeks), whereas the proportion of those with a favorable prognosis in the severe group remained stable (73% for PFS and 62% for OS within 8 weeks). Therefore, the absence of ≥grade 2 skin rash within 8 weeks may be predictive of unfavorable efficacy of cetuximab plus irinotecan in mCRC patients.
西妥昔单抗的疗效与皮肤毒性的严重程度相关，尽管其发作时间可能有所不同。本回顾性研究的目的是调查皮疹作为西妥昔单抗联合伊立替康疗效预测指标的最佳观察期。研究对象包括33例KRAS野生型转移性结直肠癌（mCRC）患者，这些患者之前接受过氟尿嘧啶、伊立替康和奥沙利铂的化疗。根据西妥昔单抗开始使用后2、4、6或8周内是否出现≥2级皮疹，比较缓解率（RR）、无进展生存期（PFS）和总生存期（OS）。总体RR为45%（15/33），中位PFS和OS分别为188天和383天。共有26例患者在8周内出现≥2级皮疹。出现≥2级皮疹的患者（严重组）中缓解者的比例随观察期的延长而降低（8周内为50%），而<2级皮疹的患者（轻度组）中无缓解者的比例增加（8周内为71%）。同样，轻度组中预后不良（PFS<6个月，OS<1年）的患者比例增加（8周内PFS为86%，OS为71%），而严重组中预后良好的患者比例保持稳定（8周内PFS为73%，OS为62%）。因此，8周内未出现≥2级皮疹可能预示西妥昔单抗联合伊立替康对mCRC患者疗效不佳。
