Journal
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY
Volume 77, Issue 1, Pages 79-85Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.critrevonc.2009.11.005
Keywords
Cetuximab; Monotherapy; Elderly patients; Colorectal cancer; EGFR
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Purpose: To evaluate the efficacy and safety of first-line single-agent cetuximab in fit elderly patients with metastatic colorectal cancer, as well as potential molecular predictive factors for efficacy. Patients and methods: Patients aged 70 or older with metastatic CRC without criteria for frailty and no prior treatment for advanced disease were treated with single-agent cetuximab 400 mg/m(2) followed by weekly 250 mg/m(2) until disease progression or unacceptable toxicity. Results: Forty-one patients were included. Two patients achieved a complete response and 4 patients had a partial response for an overall response rate of 14.6%. Fifteen patients (36.6%) remained stable. Median time to progression was 2.9 months and median overall survival 11.1 months despite two-third of patients received chemotherapy at progression. Forty-five percent of EGFR gene copy number positive patients by FISH were progression-free at 12 weeks, in contrast with 12% of FISH negative patients (p = 0.04). Grade 3 skin toxicity was reported in 5 patients (12.2%). Hypersensitivity infusion reactions were not reported and there were no toxic deaths. Conclusion: Cetuximab is a safe monoclonal antibody with moderate activity in first-line metastatic colorectal cancer, but the present study does not support the use of cetuximab as single-agent in first-line fit elderly patients with metastatic CRC. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
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