Panitumumab use in metastatic colorectal cancer and patterns of RAS testing: results from a Europe-wide physician survey and medical records review

BMC Cancer

Research Article

Gaston Demonty¹  Gerald Downey²  Parijan Parkar³  George Kafatos³  James Bennett³  Etienne Rouleau⁴  Pilar García-Alfonso⁵  Laurent Mineur⁶  Jiří Tomášek⁷  Pavel Fabian⁷  J. Han van Krieken⁸  Jörg Trojan⁹  Giovanna De Maglio^1,10  Giuseppe Aprile^1,10 

[1] Amgen GmbH, Zug, Switzerland;Amgen Ltd, Cambridge, UK;Amgen Ltd, Uxbridge, UK;Curie Institute, Paris, France;Gregorio Marañón Hospital, Madrid, Spain;Institute Sainte Catherine, Avignon, France;Masaryk Memorial Cancer Institute, Faculty of Medicine, Masaryk University, Brno, Czech Republic;Radboud University Medical Center, Nijmegen, Netherlands;University Hospital, Frankfurt, Germany;University and General Hospital, Udine, Italy;

关键词: Panitumumab;    Metastatic colorectal cancer;    mCRC;    RAS;    Physician survey;    Medical records review;   

DOI  :  10.1186/s12885-017-3740-4

 received in 2016-04-14, accepted in 2017-10-31,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIn Europe, treatment of metastatic colorectal cancer (mCRC) with panitumumab requires prior confirmation of RAS wild-type mutation status. Two studies – a physician survey and a medical records review (MRR) – were conducted to evaluate the use of panitumumab and awareness among prescribing oncologists of the associated RAS testing requirements in clinical practice.MethodsBoth studies enrolled participants from nine European countries and were carried out in three consecutive rounds. Rounds 1 and 2 (2012–2013) examined KRAS (exon 2) testing only; the results have been published in full previously. Round 3 (2014–2015) examined full RAS testing (exons 2, 3, 4 of KRAS and NRAS) and was initiated following a change in prescribing guidelines, from requiring KRAS alone to requiring full RAS testing. For the physician survey, telephone interviews were conducted with oncologists who had prescribed panitumumab to patients with mCRC in the previous 6 months. For the MRR, oncologists were asked to provide anonymised clinical information, extracted from their patients’ records.ResultsIn Round 3, 152 oncologists and 131 patients’ records were included in the physician survey and MRR, respectively. In Round 3 of the physician survey, 95.4% (n = 145) of participants correctly identified that panitumumab should only be prescribed in RAS wild-type mCRC compared with 99.0% (n = 298) of 301 participants in Rounds 1 and 2, responding to the same question about KRAS testing. In Round 3 of the MRR, 100% (n = 131) of patients included in the study had confirmed KRAS or RAS wild-type status prior to initiation of panitumumab compared with 97.7% (n = 299) of 306 patients in Rounds 1 and 2 (KRAS only). Of those patients in Round 3, 83.2% (n = 109) had been tested for RAS status and 16.8% (n = 22) had been tested for KRAS status only.ConclusionsPhysicians’ adherence to prescribing guidelines has remained high over time in Europe, despite the change in indication for panitumumab treatment, from KRAS to RAS wild-type mCRC. Additionally, this study demonstrates the uptake of full RAS testing among the majority of oncologists and pathologists.

【 授权许可】

CC BY   
© The Author(s). 2017