Kajitani Tatsuhiro, Makiyama Akitaka, Arita Shuji, Shimokawa Hozumi, Oda Hisanobu, Shirakawa Tsuyoshi, Baba Eishi, Esaki Taito
Department of Gastrointestinal and Medical Oncology, National Kyushu Cancer Center, Fukuoka, Japan.
Department of Medical Oncology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Anticancer Res. 2017 Nov;37(11):6459-6468. doi: 10.21873/anticanres.12101.
BACKGROUND/AIM: Readministration of anti-epidermal growth factor receptor (EGFR) antibody for metastatic colorectal cancer (mCRC) after disease progression remains to be determined.
Readministration of anti-EGFR antibody in mCRC patients previously refractory to anti-EGFR antibody was prospectively observed.
A total of thirteen patients with a median age of 60-years old and an Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1, were enrolled. The median number of previous chemotherapies was 3 (range 2-5). Prior anti-EGFR antibody in combination with cytotoxic drugs was administered in 12 patients. Anti-EGFR antibody readministration regimens were cetuximab/panitumumab plus capecitabine/S-1 (seven patients), panitumumab plus FOLFOX (three patients), cetuximab plus irinotecan (two patients), and panitumumab monotherapy (one patient). Seven patients showed stable disease following readministration and six patients showed progressive disease. The median overall survival (OS) following readministration was 228 days and the median PFS was 102 days. Patients with intervals longer than 90 days between anti-EGFR therapies exhibited more favorable survival than those with intervals shorter than 90 days. Switching of anti-EGFR antibody between treatments was observed to contribute survival.
Anti-EGFR antibody readministration could show a modest survival benefit in mCRC patients, with the length of therapy interval and switching of antibody being important contributory factors.
背景/目的：转移性结直肠癌（mCRC）疾病进展后再次给予抗表皮生长因子受体（EGFR）抗体的疗效仍有待确定。
前瞻性观察先前对抗EGFR抗体难治的mCRC患者再次给予抗EGFR抗体的情况。
共纳入13例患者，中位年龄60岁，东部肿瘤协作组（ECOG）体能状态为0或1。既往化疗的中位次数为3次（范围2 - 5次）。12例患者先前接受过抗EGFR抗体联合细胞毒性药物治疗。再次给予抗EGFR抗体的方案为西妥昔单抗/帕尼单抗联合卡培他滨/S-1（7例患者）、帕尼单抗联合FOLFOX（3例患者）、西妥昔单抗联合伊立替康（2例患者）以及帕尼单抗单药治疗（1例患者）。再次给药后7例患者疾病稳定，6例患者疾病进展。再次给药后的中位总生存期（OS）为228天，中位无进展生存期（PFS）为102天。抗EGFR治疗间隔时间超过90天的患者比间隔时间短于90天的患者生存情况更有利。观察到治疗期间抗EGFR抗体的转换有助于生存。
再次给予抗EGFR抗体对mCRC患者可能有一定的生存获益，治疗间隔时间长短和抗体转换是重要的影响因素。
