探索一线EGFR抑制剂西妥昔单抗与帕尼单抗在左侧RAS野生型转移性结直肠癌患者中的实际结果

IF 3.2 3区医学 Q2 ONCOLOGY

Clinical colorectal cancer Pub Date : 2025-04-30 DOI:10.1016/j.clcc.2025.04.001

Jane McKenzie , Vanessa Wong , Shehara Mendis , Rachel Wong , Suzanne Kosmider , Yat Hang To , Louise Nott , Jeremy Shapiro , Javier Torres , Belinda Lee , Azim Jalali , Stephanie Hui-Su Lim , Susan Caird , Adnan Khattak , Peter Gibbs

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引用次数: 0

摘要

背景：表皮生长因子受体抑制剂（EGFRi），最常见的是西妥昔单抗和帕尼单抗，是左侧RAS野生型（RASwt）转移性结直肠癌患者的一线选择。比较EGFRi结果的数据有限。方法：2015年1月至2024年10月诊断的患者数据来自TRACC，这是一项前瞻性，多地点的澳大利亚结直肠癌登记处。确定了使用EGFRi作为一线（1l）治疗的左侧RASwt疾病患者。生存结果采用Kaplan-Meir法计算。结果：我们确定了747例左侧转移性结直肠癌患者。其中，287例（38%）接受了1 L治疗，包括西妥昔单抗（n = 210, 73%）或帕尼单抗（n = 77,27%）。7例患者均因皮肤毒性而从一种药物切换到另一种药物，包括6例（7.8%）最初使用帕尼单抗治疗，1例（0.5%）最初使用西妥昔单抗治疗。转换后，使用第二种EGFRi药物的中位时间为212天。在242例接受EGFRi联合双重化疗的患者中，毒性导致帕尼单抗治疗的患者更常停止治疗（32%对13%，P = 0.003）。对于以姑息治疗为目的的患者亚组（n = 156），两种EGFRi的中位无进展期（P = 0.43）和总生存期（P = 0.98）相似。结论：在这个现实世界的分析中，在存在皮肤毒性的情况下，从一种EGFRi药物切换到另一种EGFRi药物会导致替代EGFRi的持久治疗效果。对于接受一线西妥昔单抗或帕尼单抗联合双重化疗的患者，EGFRi药物的毒性相关治疗停止率不同。在生存结果方面未见差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Exploring Real-World Outcomes of First Line EGFR Inhibitor Use, Cetuximab Versus Panitumumab, in Patients with Left-Sided, RAS Wild-Type, Metastatic Colorectal Cancer

Background

Epidermal growth factor receptor inhibitors (EGFRi), most commonly cetuximab and panitumumab, are first-line options for patients with left-sided, RAS wildtype (RASwt) metastatic colorectal cancer. Limited data is available comparing EGFRi outcomes.

Methods

Data for patients diagnosed January 2015 to October 2024 was reviewed from TRACC, a prospective, multi-site Australasian colorectal cancer registry. Patients with left-sided, RASwt disease treated with an EGFRi as first-line (1 L) therapy were identified. Survival outcomes were calculated using Kaplan-Meir methods.

Results

We identified 747 patients with RASwt, left-sided, metastatic colorectal cancer. Of these, 287 (38%) received 1 L therapy that included cetuximab (n = 210, 73%) or panitumumab (n = 77, 27%). A switch from one to the other agent occurred in seven patients, all due to skin toxicity, including six patients (7.8%) initially treated with panitumumab and 1 (0.5%) initially treated with cetuximab. After switching, median time on the second EGFRi agent was 212 days. For 242 patients treated with an EGFRi in combination with doublet chemotherapy, toxicity contributed to treatment cessation more often in patients treated with panitumumab (32% vs. 13%, P = .003). For the subset of patients treated with palliative intent (n = 156), median progression-free (P = .43) and overall survival (P = .98) were similar for both EGFRi.

Conclusion

In this real-world analysis, a switch from one EGFRi agent to the other in the presence of skin toxicity led to durable treatment benefit with the alternate EGFRi. For patients receiving first-line cetuximab or panitumumab in combination with doublet chemotherapy, toxicity-related treatment cessation rates differed between EGFRi agents. No differences were seen in survival outcomes.

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来源期刊

Clinical colorectal cancer 医学-肿瘤学

CiteScore

5.50

自引率

2.90%

发文量

审稿时长

27 days

期刊介绍： Clinical Colorectal Cancer is a peer-reviewed, quarterly journal that publishes original articles describing various aspects of clinical and translational research of gastrointestinal cancers. Clinical Colorectal Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of colorectal, pancreatic, liver, and other gastrointestinal cancers. The main emphasis is on recent scientific developments in all areas related to gastrointestinal cancers. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.