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

Cancer Communications

Feng-Hua Wang¹  Chao Ren¹  De-Shen Wang¹  Rui-Hua Xu¹  Dong-Sheng Zhang¹  Yi-Yi Yu¹  Long Bai¹  Miao-Zhen Qiu²  Feng Wang²  Yu-Hong Li²  Tian-Shu Liu²  Hui-Yan Luo²  Zhi-Qiang Wang²  Yin Jin²  Ming-Ming He³  Kai-Yan Liu³ 

[1] Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China;Department of Medical Oncology, Sun Yat-sen University Cancer Center: State Key Laboratory of Oncology in South China;Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China

关键词: Colorectal neoplasms;    Cetuximab;    Left-sided;    Right-sided;    Chemotherapy;   

DOI  :  10.1186/s40880-015-0022-x

学科分类：肿瘤学

来源: Springer

【 摘 要 】

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

【 授权许可】

CC BY