Impact of Delayed Addition of Anti-EGFR Monoclonal Antibodies on the Outcome of First-Line Therapy in Metastatic Colorectal Cancer Patients: a Retrospective Registry-Based Analysis

• Published in: Targeted oncology 2018-12, Vol.13 (6), p.735-743
• Main Authors: Fiala, Ondrej, Veskrnova, Veronika, Chloupkova, Renata, Poprach, Alexandr, Kiss, Igor, Kopeckova, Katerina, Dusek, Ladislav, Slavicek, Lubomir, Kohoutek, Milan, Finek, Jindrich, Svoboda, Marek, Petruzelka, Lubos, Boubliková, Ludmila, Dvorak, Josef, Melichar, Bohuslav, Buchler, Tomas
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antibodies, Monoclonal - pharmacology; Antibodies, Monoclonal - therapeutic use; Biomedicine; Chemotherapy; Colorectal cancer; Colorectal Neoplasms - drug therapy; Colorectal Neoplasms - pathology; Epidermal growth factor; Female; Humans; Male; Medicine; Medicine & Public Health; Metastasis; Middle Aged; Monoclonal antibodies; Neoplasm Metastasis; Oncology; Original Research Article; Registries; Retrospective Studies; Targeted cancer therapy
• ISSN: 1776-2596; 1776-260X
• DOI: 10.1007/s11523-018-0597-7

Background The addition of monoclonal antibodies targeting the epidermal growth factor receptor (anti-EGFR Abs) to chemotherapy for metastatic colorectal carcinoma (mCRC) is commonly delayed in the real-world clinical practice, usually because of late RAS testing results. Objective To determine whether delayed addition of anti-EGFR mAbs up to the fourth cycle of backbone chemotherapy adversely affected outcomes of mCRC patients treated with first-line regimens. Patients and Methods Clinical data of patients with histologically verified, RAS wild-type mCRC treated with first-line systemic therapy regimens containing anti-EGFR mAbs were retrospectively analysed from a national database. Patients were divided into three groups according to the timing of anti-EGFR mAbs addition to the chemotherapy backbone. Cohort A ( n  = 401) included patients in whom anti-EGFR mAbs were added to chemotherapy from the first cycle, cohort B ( n  = 71) patients with anti-EGFR mAbs added to chemotherapy from the second cycle, and cohort C ( n  = 101) patients who had anti-EGFR mAbs added to chemotherapy from the third or fourth cycle. Results Three hundred and thirty-six (58.6%) patients received panitumumab and 237 (41.4%) patients received cetuximab. The median progression-free survival (PFS) of the whole cohort was 12.2 months (95% confidence interval [CI] 10.9–13.5), and the median overall survival (OS) was 33.5 months (95% CI 27.6–39.4). The median PFS and OS for patients treated with anti-EGFR mAbs added to chemotherapy were 12.9 (95% CI 11.5–14.3) and 30.6 months (95% CI 25.2–36.1) for cohort A, 9.7 (95% CI 9.1–10.3) and not reached for cohort B, compared to 11.5 (95% CI 9.8–13.2) and 37.9 months (95% CI 28.6–47.3) for cohort C, respectively. Conclusions Delayed addition of anti-EGFR mAbs to first-line chemotherapy was not associated with inferior survival or response rates.