Irinotecan combined with Panitumumab or cetuximab as third-line treatment for metastatic colorectal cancer.

Authors

null

Maria Ignez Braghiroli

Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil

Maria Ignez Braghiroli , Maria Fernanda Batistuzzo Vicentini , Leonardo Gomes da Fonseca , Karla Teixeira Souza , Renata Colombo Bonadio , Oddone Freitas Melro Braghiroli , Maria Cecília Machado Mathias , Aley Talans , Maria Elizabeth Zambrano Mendoza , Juliana Goes Martins , Jorge Sabagga , Camila Venchiarutti Motta Venchiarutti Moniz , Paulo Marcelo Hoff

Organizations

Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil, Insituto do Câncer do Estado de São Paulo, São Paulo, Brazil, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, São Paulo, Brazil, Instituto do Câncer de São Paulo Octavio Frias de Oliveira, São Paulo, Brazil, ICESP, São Paulo, Brazil, Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil

Research Funding

No funding received

Background: Literature suggests that the addition of cetuximab can overcome the resistance to irinotecan treatment for metastatic colorectal cancer (mCRC). It is unknown if the combination of panitumumab with irinotecan could also revert treatment resistance and offer a better response rate after progression on irinotecan monotherapy. In this study, we aim to compare the impact of panitumumab plus irinotecan (P+I) or cetuximab plus irinotecan (C+I) on overall survival as a third line mCRC treatment. Methods: This is a single institution, retrospective cohort analysis, evaluating the overall survival of mCRC patients exposed to an anti-EGFR antibody plus irinotecan, upon progression on irinotecan monotherapy. Overall survival function was estimated using the Kaplan-Meier method and compared using the log-rank test. Results: We identified 460 patients with mCRC that fulfilled inclusion criteria, treated between July 2008 and April 2018. One hundred eighty-three (183) patients received (I+C), and 277 received (I+P). Upon diagnosis, the median age was 55.9 years (range, 19 - 83 years), with a male to female ratio of 1.3:1. All patients received the combination of irinotecan and anti-EGFR targeting antibodies for at least one cycle (D1 and D15). Partial response occurred in 22.6% of patients [23.5% for (I+C) and 22.0% for (I+P)], and 25,2% had stable disease [27.8% for (I+C) and 23.6% for (I+P)]. Interestingly, response rate in patients with right-sided tumors was 3.3% in the (I+C) regimen and 14.3% in the (I+P) regimen. The disease control rate was 50.3% in the (I+C) combination and 45.7% in the (I+P) combination (p = 0.358). The median overall survival (mOS) for all patients was 9.63 months, 8.97 to the group C+I and 10.74 to P+I (p = 0.73). Regarding primary tumor location, the mOS was 6.34 mo for right-sided tumors and 10.74 mo for left-sided tumors (p = 0.022). The 3-year survival rate was 5.6% for the (C+I) treated patients and 3.2% for (P+I). Conclusions: (P+I) and (C+I) combinations showed similar response rate and mOS as a third-line treatment for mCRC, suggesting that both anti-EGFR agents can be used in this setting. A perceived tendency for a superior response with the (I+P) regimen in right-sided tumors might warrant further investigation in prospective studies.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Gastrointestinal Cancer—Colorectal and Anal

Track

Gastrointestinal Cancer—Colorectal and Anal

Sub Track

Colorectal Cancer–Advanced Disease

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr e15551)

DOI

10.1200/JCO.2022.40.16_suppl.e15551

Abstract #

e15551

Abstract Disclosures

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