Johnson Braden M, Pham Tony A, Young Kate J, Bantis Leonidas E, Sun Weijing, Kasi Anup
Department of Medical Oncology, University of Kansas Medical Center, Kansas City, KS.
Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS.
Kans J Med. 2022 Aug 22;15(2):273-277. doi: 10.17161/kjm.vol15.15975. eCollection 2022.
Colon cancer impacts the lives of Kansans and those across the United States. Epidermal growth factor receptor (EGFR) inhibitors, such as panitumumab and cetuximab, have gained popularity as first-line treatment for stage 4 colon cancer despite their toxicities and have been used by clinicians in later lines of therapy. EGFR inhibitors have been proven to be an efficacious first-line treatment for stage 4 colon cancer, but no study has investigated outcomes comparing EGFR inhibitors as first-line treatment to its use as second- or third-line treatment. This study investigated EGFR inhibitor therapy estimated overall survival when used as first-, second-, and third-line treatment for stage 4 colon cancer.
A retrospective review was done for patients with stage 4 colon cancer who underwent EGFR inhibitor treatment at a large academic center from November 2007 to August 2021. The patients were stratified into five groups by the line in which they received the EGFR inhibitor treatment. A log-rank test was used to analyze the groups, and the median survival for each group was determined.
A total of 68 patients were reviewed; 18 received first-line, 23 received second-line, 18 received third-line, 6 received fourth-line, and 3 received sixth-line treatment with an EGFR inhibitor. Fourth- and sixth-line therapies were excluded due to small patient size. There was no significant difference in estimated survival time between any of the lines. Median survival of the therapies was found.
There was no statistical difference in survival between the first-, second-, or third-line groups, which may provide justification for its use as a second- or third-line therapy.
结肠癌影响着堪萨斯州以及美国其他地区民众的生活。表皮生长因子受体（EGFR）抑制剂，如帕尼单抗和西妥昔单抗，尽管存在毒性，但作为晚期结肠癌的一线治疗药物已越来越受欢迎，并且临床医生也将其用于后续治疗。EGFR抑制剂已被证明是晚期结肠癌有效的一线治疗药物，但尚无研究比较EGFR抑制剂作为一线治疗与二线或三线治疗的效果。本研究调查了EGFR抑制剂治疗晚期结肠癌一线、二线和三线治疗的总生存期。
对2007年11月至2021年8月在某大型学术中心接受EGFR抑制剂治疗的晚期结肠癌患者进行回顾性研究。根据接受EGFR抑制剂治疗的先后顺序将患者分为五组。采用对数秩检验分析各组情况，并确定每组的中位生存期。
共纳入68例患者；18例接受一线治疗，23例接受二线治疗，18例接受三线治疗，6例接受四线治疗，3例接受六线EGFR抑制剂治疗。由于四线和六线治疗的患者数量较少，故将其排除。各治疗线之间的估计生存时间无显著差异。计算出各治疗线的中位生存期。
一线、二线或三线治疗组之间的生存率无统计学差异，这可能为将其用作二线或三线治疗提供依据。
