内容紹介
Efficacy and Safety of Panitumumab for K-Ras Wild-Type Unresectable or Recurrent Colorectal Cancer―A Study Focusing on First-Line Treatment
Summary
Panitumumab was approved in June 2010 for use in the treatment of unresectable advanced/recurrent colorectal cancer. Here, we report outcomes and adverse events of panitumumab combination therapy or single-agent chemotherapy for K-ras wild-type unresectable or recurrent colorectal cancers. Our study focused on first-line treatments. The study involved 18 patients who started receiving panitumumab in October 2010. Nine patients received panitumumab as a first-line treatment; 4, as a second-line treatment; and 5, as a third-line or subsequent treatment. The overall response rate was 27.8%. Among the patients who received panitumumab as a first-line treatment, the response rate was 55.6%. Grade 1 and 2 skin disorders were common adverse events. Grade 2 interstitial pneumonia was observed in 1 patient(5.6%). Grade 3 or higher events comprised peripheral neuropathy in 1 patient(5.6%)and neutropenia in another patient(5.6%). The treatment was beneficial, and metastatic foci were resected in 3 patients. In this study, the only adverse events of Grade 3 or higher were 1 case each of peripheral neuropathy and neutropenia. Accordingly, adequate control seemed possible. The specific line of treatment that panitumumab should belong to remains controversial. However, active initiation as first-line treatment should be considered for cases in which resection of metastatic foci can be expected from tumor reductions due to panitumumab.
要旨
K-ras遺伝子野生型切除不能・再発大腸癌に対し,panitumumab併用あるいは単剤化学療法を施行した治療成績と有害事象について一次治療を中心に検討した。2010年10月からpanitumumabを投与開始した18症例を対象とした。治療ラインは一次/二次/三次以降の治療が9例/4例/5例,奏効率は全体で27.8%,一次治療で使用した症例では55.6%であった。有害事象はGrade 1あるいはGrade 2の皮膚障害が多く,またGrade 2の間質性肺炎を1例(5.6%)認めた。Grade 3以上は,末梢神経障害1例(5.6%),好中球減少1例(5.6%)であった。治療が奏効し,転移巣切除を施行した症例を3例認めた。今回の検討において,Grade 3以上の有害事象は末梢神経障害1例,好中球減少1例のみであり,十分にコントロール可能と思われた。panitumumabをどの治療ラインで使用するかは未だcontroversialであるが,panitumumabの腫瘍縮小効果により転移巣切除が期待できる症例には積極的に一次治療からの導入を検討すべきであると考えられた。
目次
Summary
Panitumumab was approved in June 2010 for use in the treatment of unresectable advanced/recurrent colorectal cancer. Here, we report outcomes and adverse events of panitumumab combination therapy or single-agent chemotherapy for K-ras wild-type unresectable or recurrent colorectal cancers. Our study focused on first-line treatments. The study involved 18 patients who started receiving panitumumab in October 2010. Nine patients received panitumumab as a first-line treatment; 4, as a second-line treatment; and 5, as a third-line or subsequent treatment. The overall response rate was 27.8%. Among the patients who received panitumumab as a first-line treatment, the response rate was 55.6%. Grade 1 and 2 skin disorders were common adverse events. Grade 2 interstitial pneumonia was observed in 1 patient(5.6%). Grade 3 or higher events comprised peripheral neuropathy in 1 patient(5.6%)and neutropenia in another patient(5.6%). The treatment was beneficial, and metastatic foci were resected in 3 patients. In this study, the only adverse events of Grade 3 or higher were 1 case each of peripheral neuropathy and neutropenia. Accordingly, adequate control seemed possible. The specific line of treatment that panitumumab should belong to remains controversial. However, active initiation as first-line treatment should be considered for cases in which resection of metastatic foci can be expected from tumor reductions due to panitumumab.
要旨
K-ras遺伝子野生型切除不能・再発大腸癌に対し,panitumumab併用あるいは単剤化学療法を施行した治療成績と有害事象について一次治療を中心に検討した。2010年10月からpanitumumabを投与開始した18症例を対象とした。治療ラインは一次/二次/三次以降の治療が9例/4例/5例,奏効率は全体で27.8%,一次治療で使用した症例では55.6%であった。有害事象はGrade 1あるいはGrade 2の皮膚障害が多く,またGrade 2の間質性肺炎を1例(5.6%)認めた。Grade 3以上は,末梢神経障害1例(5.6%),好中球減少1例(5.6%)であった。治療が奏効し,転移巣切除を施行した症例を3例認めた。今回の検討において,Grade 3以上の有害事象は末梢神経障害1例,好中球減少1例のみであり,十分にコントロール可能と思われた。panitumumabをどの治療ラインで使用するかは未だcontroversialであるが,panitumumabの腫瘍縮小効果により転移巣切除が期待できる症例には積極的に一次治療からの導入を検討すべきであると考えられた。