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Right- and left-sided colorectal cancers respond differently to cetuximab.

Wang F, Bai L, Liu TS, Yu YY, He MM, Liu KY, Luo HY, Zhang DS, Jin Y, Wang FH, Wang ZQ, Wang DS, Qiu MZ, Ren C, Li YH, Xu RH - Chin J Cancer (2015)

Bottom Line: The differences in the outcome were analyzed by using the chi-squared test, Student's t test, and Kaplan-Meier method.However, cetuximab neither improved the ORR (36.4 % vs. 26.2 %, P = 0.349) nor prolonged PFS (5.6 vs. 5.7 months, P = 0.904) or OS (25.1 vs. 19.8 months, P = 0.553) in patients with RSCC.In contrast, as a second-line treatment, cetuximab neither improved the ORR (7.1 % vs. 11.4 %, P = 0.698) nor prolonged PFS (3.3 vs. 4.2 months, P = 0.761) or OS (13.4 vs. 13.0 months, P = 0.652) in patients with RSCC.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center: State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, P. R. China. wangfeng@sysucc.org.cn.

ABSTRACT

Introduction: Right-sided colon cancer (RSCC) and left-sided colorectal cancer (LSCRC) differ with respect to their biology and genomic patterns. This study aimed to examine whether the primary tumor location is associated with the response to cetuximab in patients with metastatic colorectal cancer (mCRC).

Methods: Patients with mCRC treated with cetuximab and standard chemotherapy as first- or second-line treatments were compared with randomly chosen patients who were treated with chemotherapy alone between 2005 and 2013. The main outcome measures were the overall response rate (ORR), progression-free survival (PFS), and overall survival (OS). The differences in the outcome were analyzed by using the chi-squared test, Student's t test, and Kaplan-Meier method.

Results: The treatment results of 206 patients with mCRC treated with cetuximab and standard chemotherapy as first- or second-line treatments were compared with those of 210 patients who were treated with chemotherapy alone. As a first-line treatment, cetuximab with chemotherapy was associated with a significantly higher ORR (49.4 % vs. 28.6 %, P = 0.005) as well as longer PFS (9.1 vs. 6.2 months, P = 0.002) and OS (28.9 vs. 20.1 months, P = 0.036) than chemotherapy alone in patients with LSCRC. However, cetuximab neither improved the ORR (36.4 % vs. 26.2 %, P = 0.349) nor prolonged PFS (5.6 vs. 5.7 months, P = 0.904) or OS (25.1 vs. 19.8 months, P = 0.553) in patients with RSCC. As a second-line treatment, cetuximab exhibited a tendency to improve the ORR (23.5 % vs. 10.2 %, P = 0.087) and prolong PFS (4.9 vs. 3.5 months, P = 0.064), and it significantly prolonged OS (17.1 vs. 12.4 months, P = 0.047) compared with chemotherapy alone in the patients with LSCRC. In contrast, as a second-line treatment, cetuximab neither improved the ORR (7.1 % vs. 11.4 %, P = 0.698) nor prolonged PFS (3.3 vs. 4.2 months, P = 0.761) or OS (13.4 vs. 13.0 months, P = 0.652) in patients with RSCC.

Conclusions: The addition of cetuximab to chemotherapy in both first- and second-line treatments of mCRC may only benefit patients with primary LSCRC.

No MeSH data available.


Related in: MedlinePlus

Kaplan–Meier survival estimates of metastatic colorectal cancer patients with first-line therapy. a, progression-free survival (PFS) curves of right-sided colon cancer (RSCC) patients. b, overall survival (OS) curves of RSCC patients. c, PFS curves of left-sided colorectal cancer (LSCRC) patients. d, OS curves of LSCRC patients
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Fig1: Kaplan–Meier survival estimates of metastatic colorectal cancer patients with first-line therapy. a, progression-free survival (PFS) curves of right-sided colon cancer (RSCC) patients. b, overall survival (OS) curves of RSCC patients. c, PFS curves of left-sided colorectal cancer (LSCRC) patients. d, OS curves of LSCRC patients

Mentions: In RSCC patients who received first-line chemotherapy, the median PFS (5.6 vs. 5.7 months, P = 0.904) (Fig. 1a) and OS (25.1 vs. 19.8 months, P = 0.553) (Fig. 1b) were comparable between those who received cetuximab with chemotherapy and chemotherapy alone. On the other hand, first-line treatment with cetuximab plus chemotherapy resulted in a significantly longer median PFS (9.1 vs. 6.2 months, P = 0.002) (Fig. 1c) and OS (28.9 vs. 20.1 months, P = 0.036) (Fig. 1d) compared with chemotherapy alone in patients with LSCRC.Fig. 1


Right- and left-sided colorectal cancers respond differently to cetuximab.

Wang F, Bai L, Liu TS, Yu YY, He MM, Liu KY, Luo HY, Zhang DS, Jin Y, Wang FH, Wang ZQ, Wang DS, Qiu MZ, Ren C, Li YH, Xu RH - Chin J Cancer (2015)

Kaplan–Meier survival estimates of metastatic colorectal cancer patients with first-line therapy. a, progression-free survival (PFS) curves of right-sided colon cancer (RSCC) patients. b, overall survival (OS) curves of RSCC patients. c, PFS curves of left-sided colorectal cancer (LSCRC) patients. d, OS curves of LSCRC patients
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4593341&req=5

Fig1: Kaplan–Meier survival estimates of metastatic colorectal cancer patients with first-line therapy. a, progression-free survival (PFS) curves of right-sided colon cancer (RSCC) patients. b, overall survival (OS) curves of RSCC patients. c, PFS curves of left-sided colorectal cancer (LSCRC) patients. d, OS curves of LSCRC patients
Mentions: In RSCC patients who received first-line chemotherapy, the median PFS (5.6 vs. 5.7 months, P = 0.904) (Fig. 1a) and OS (25.1 vs. 19.8 months, P = 0.553) (Fig. 1b) were comparable between those who received cetuximab with chemotherapy and chemotherapy alone. On the other hand, first-line treatment with cetuximab plus chemotherapy resulted in a significantly longer median PFS (9.1 vs. 6.2 months, P = 0.002) (Fig. 1c) and OS (28.9 vs. 20.1 months, P = 0.036) (Fig. 1d) compared with chemotherapy alone in patients with LSCRC.Fig. 1

Bottom Line: The differences in the outcome were analyzed by using the chi-squared test, Student's t test, and Kaplan-Meier method.However, cetuximab neither improved the ORR (36.4 % vs. 26.2 %, P = 0.349) nor prolonged PFS (5.6 vs. 5.7 months, P = 0.904) or OS (25.1 vs. 19.8 months, P = 0.553) in patients with RSCC.In contrast, as a second-line treatment, cetuximab neither improved the ORR (7.1 % vs. 11.4 %, P = 0.698) nor prolonged PFS (3.3 vs. 4.2 months, P = 0.761) or OS (13.4 vs. 13.0 months, P = 0.652) in patients with RSCC.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center: State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, P. R. China. wangfeng@sysucc.org.cn.

ABSTRACT

Introduction: Right-sided colon cancer (RSCC) and left-sided colorectal cancer (LSCRC) differ with respect to their biology and genomic patterns. This study aimed to examine whether the primary tumor location is associated with the response to cetuximab in patients with metastatic colorectal cancer (mCRC).

Methods: Patients with mCRC treated with cetuximab and standard chemotherapy as first- or second-line treatments were compared with randomly chosen patients who were treated with chemotherapy alone between 2005 and 2013. The main outcome measures were the overall response rate (ORR), progression-free survival (PFS), and overall survival (OS). The differences in the outcome were analyzed by using the chi-squared test, Student's t test, and Kaplan-Meier method.

Results: The treatment results of 206 patients with mCRC treated with cetuximab and standard chemotherapy as first- or second-line treatments were compared with those of 210 patients who were treated with chemotherapy alone. As a first-line treatment, cetuximab with chemotherapy was associated with a significantly higher ORR (49.4 % vs. 28.6 %, P = 0.005) as well as longer PFS (9.1 vs. 6.2 months, P = 0.002) and OS (28.9 vs. 20.1 months, P = 0.036) than chemotherapy alone in patients with LSCRC. However, cetuximab neither improved the ORR (36.4 % vs. 26.2 %, P = 0.349) nor prolonged PFS (5.6 vs. 5.7 months, P = 0.904) or OS (25.1 vs. 19.8 months, P = 0.553) in patients with RSCC. As a second-line treatment, cetuximab exhibited a tendency to improve the ORR (23.5 % vs. 10.2 %, P = 0.087) and prolong PFS (4.9 vs. 3.5 months, P = 0.064), and it significantly prolonged OS (17.1 vs. 12.4 months, P = 0.047) compared with chemotherapy alone in the patients with LSCRC. In contrast, as a second-line treatment, cetuximab neither improved the ORR (7.1 % vs. 11.4 %, P = 0.698) nor prolonged PFS (3.3 vs. 4.2 months, P = 0.761) or OS (13.4 vs. 13.0 months, P = 0.652) in patients with RSCC.

Conclusions: The addition of cetuximab to chemotherapy in both first- and second-line treatments of mCRC may only benefit patients with primary LSCRC.

No MeSH data available.


Related in: MedlinePlus