Cetuximab in the first-line treatment of K-ras wild-type metastatic colorectal cancer: The choice and schedule of fluoropyrimidine matters

Geoffrey Y. Ku, Benjamin A. Haaland, Gilberto De Lima Lopes

Research output: Contribution to journalArticle

Abstract

Background Cetuximab, a monoclonal antibody against the epidermal growth factor receptor, inconsistently improves response rates (RR), progression-free survival (PFS) and overall survival (OS) in the first-line treatment of advanced colorectal cancer patients with K-ras wildtype (WT) tumors. Methods We performed a meta-analysis of four trials where K-ras WT Pts received a fluoropyrimidine (infusional vs. bolus 5-fluorouracil (5-FU) vs. capecitabine) and oxaliplatin or irinotecan with and without cetuximab (CRYSTAL, OPUS, COIN and NORDIC VII trials) and two trials, where K-ras WT and mutant patients received cetuximab and a fluoropyrimidine (capecitabine in a German AIO study and infusional 5-FU in the CECOG study) with oxaliplatin versus irinotecan. We sought to determine whether the choice of fluoropyrimidine or of oxaliplatin versus irinotecan affects the response to cetuximab. Meta-analysis was performed in the context of a mixed effects model with a random effect for each study. Results Only patients treated with infusional 5-FU-based chemotherapy derived benefit from cetuximab. Relative to infusional 5-FU, patients treated with capecitabine/bolus 5-FU-based doublet chemotherapy had a 42 % (95 % CI 21-58 %; p

Original languageEnglish (US)
Pages (from-to)231-238
Number of pages8
JournalCancer Chemotherapy and Pharmacology
Volume70
Issue number2
DOIs
StatePublished - Aug 2012

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oxaliplatin
irinotecan
Fluorouracil
Colorectal Neoplasms
Appointments and Schedules
Chemotherapy
Meta-Analysis
Therapeutics
Drug Therapy
Epidermal Growth Factor Receptor
Disease-Free Survival
Tumors
Monoclonal Antibodies
Cetuximab
Survival
Capecitabine
Neoplasms

Keywords

  • Cetuximab
  • Chemotherapy
  • Colorectal cancer
  • Fluoropyrimidine
  • Meta-analysis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pharmacology
  • Pharmacology (medical)
  • Toxicology

Cite this

Cetuximab in the first-line treatment of K-ras wild-type metastatic colorectal cancer : The choice and schedule of fluoropyrimidine matters. / Ku, Geoffrey Y.; Haaland, Benjamin A.; De Lima Lopes, Gilberto.

In: Cancer Chemotherapy and Pharmacology, Vol. 70, No. 2, 08.2012, p. 231-238.

Research output: Contribution to journalArticle

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