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Panitumumab after progression on cetuximab in KRAS wild-type metastatic colorectal cancer patients: a single institution experience

Abstract

Aims and background

Few data describe the activity of panitumumab after cetuximab-irinotecan-based regimen failure in patients with KRAS wild-type metastatic colorectal cancer (WT MCRC).

Methods

The aim of this study is to assess if panitumumab has some activity in this setting.

Results

We retrospectively analyzed 25 patients with KRAS WT MCRC who received panitumumab from July 2009 to January 2013 after progression on cetuximab. All patients had previously received cetuximab and irinotecan (20 patients) or oxaliplatin (5 patients). We withdrew cetuximab for intolerance in 4 patients (16%). Twenty-one patients (84%) who had previously responded to cetuximab (overall response rate [ORR] plus stable disease ≥5 months) received panitumumab off-label after progression on cetuximab because they were strongly motivated to continue treatment without chemotherapy. The median number of cycles of panitumumab was 7 (range 1-54). Only 20 patients were evaluable for ORR (5 patients received 1-2 cycles and then died). We observed 1 (5%) partial response, 5 (25%) stable disease, median duration 9 months. Median progression-free survival (PFS) and overall survival (OS) were 5 (3-28) and 8 (5-41) months, respectively. All patients were evaluable for toxicity. No patients developed anemia or neutropenia. One patient (4%) developed grade 2 thrombocytopenia, 8 patients (32%) grade 2-3 dry skin or rash, and 2 patients (8%) grade 2 nausea-vomiting (Common Terminology Criteria for Adverse Events version 4.03).

Conclusions

Our data, with all the limits of a retrospective analysis, show longer PFS and OS as compared to other series in the same setting, demonstrating that panitumumab has treatment effectiveness in patients with KRAS WT MCRC who progressed on prior cetuximab. Further confirmatory prospective studies with a larger series of patients are necessary.

Tumori 2015; 101(5): 524 - 528

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000356

Authors

Antonella Marino, Chiara Caliolo, Francesco Sponziello, Angelo Nacci, Annamaria Quaranta, Enrica Mazzoni, Stefania Eufemia Lutrino, Pietro Rizzo, Nicola Calvani, Laura Orlando, Paola Schiavone, Palma Fedele, Maria D’Amico, Maria Concetta Chetrì, Margherita Cinefra, Pasqualinda Ferrara, Saverio Cinieri

Article History

Disclosures

Financial support: None.
Conflict of interest: None.

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Authors

Affiliations

  • Medical Oncology & Breast Unit, “A. Perrino” Hospital, Brindisi - Italy
  • Medicine Department, European Institute of Oncology, Milan - Italy

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