内容紹介
A Retrospective Analysis of Cetuximab or Panitumumab Monotherapy for KRAS Wild-Type Metastatic Colorectal Cancer in Clinical Practice
Summary
We performed a retrospective study on the use of cetuximab or panitumumab alone in patients with KRAS wild-type metastatic colorectal cancer between November 2008 and February 2012. Twenty-two patients were analyzed and classified as PS 0/1(good PS group)and PS 2/3/4(poor PS group)with 11 patients in each group. The response rate, disease control rate, median progression-free survival, and median overall survival were 9%, 73%, 5.1 months(95% confidence interval[CI]: 1.5-8.7), and 16 months(95% CI: 8.8-24), respectively, in the good PS group, and the corresponding values in the poor PS group were 0%, 18%, 0.7 months(95% CI: 0.3-1.0), and 1.5 months(95% CI: 0.7-2.4). Grade 3 or 4 adverse events were skin toxicities(2 patients with grade 3 toxicities), panitumumab-related interstitial lung disease(1 patient with grade 4 toxicity), and cetuximab infusion-related reaction(1 patient with grade 4 toxicity). No treatment-related deaths were observed. In conclusion, the efficacy and safety of cetuximab or panitumumab monotherapy in patients with a good PS in our study were similar to those reported in previous clinical trials, whereas patients with a poor PS showed poorer outcomes.
要旨
2008年11月～2012年2月までにcetuximabもしくはpanitumumab単剤で治療したKRAS遺伝子野生型治癒切除不能大腸癌の治療成績について,PS良好群(PS 0/1)と不良群(PS 2/3/4)に分けて後方視的に検討した。対象は22例で,PS良好群11例(PS 0/1:3/8例),PS不良群11例(PS 2/3/4:6/3/2例)だった。PS良好群と不良群の奏効率は9%と0%,病勢コントロール率は73%と18%,無増悪生存期間中央値は5.1か月[95%信頼区間(confidence interval: CI)1.5-8.7]と0.7か月(95%CI 0.3-1.0),全生存期間中央値は16か月(95%CI 8.8-24)と1.5か月(95%CI 0.7-2.4)であった。grade 3以上の有害事象は全体で18%に認められ,cetuximabで1例のinfusion reaction(grade 4)と,panitumumabで1例の間質性肺炎(grade 4)を認め,いずれも治療中止とした。治療関連死はなかった。PS良好例には実地臨床でも既報と同様の治療成績を示したが,PS 2以上には適応を慎重に検討する必要がある。
目次
Summary
We performed a retrospective study on the use of cetuximab or panitumumab alone in patients with KRAS wild-type metastatic colorectal cancer between November 2008 and February 2012. Twenty-two patients were analyzed and classified as PS 0/1(good PS group)and PS 2/3/4(poor PS group)with 11 patients in each group. The response rate, disease control rate, median progression-free survival, and median overall survival were 9%, 73%, 5.1 months(95% confidence interval[CI]: 1.5-8.7), and 16 months(95% CI: 8.8-24), respectively, in the good PS group, and the corresponding values in the poor PS group were 0%, 18%, 0.7 months(95% CI: 0.3-1.0), and 1.5 months(95% CI: 0.7-2.4). Grade 3 or 4 adverse events were skin toxicities(2 patients with grade 3 toxicities), panitumumab-related interstitial lung disease(1 patient with grade 4 toxicity), and cetuximab infusion-related reaction(1 patient with grade 4 toxicity). No treatment-related deaths were observed. In conclusion, the efficacy and safety of cetuximab or panitumumab monotherapy in patients with a good PS in our study were similar to those reported in previous clinical trials, whereas patients with a poor PS showed poorer outcomes.
要旨
2008年11月～2012年2月までにcetuximabもしくはpanitumumab単剤で治療したKRAS遺伝子野生型治癒切除不能大腸癌の治療成績について,PS良好群(PS 0/1)と不良群(PS 2/3/4)に分けて後方視的に検討した。対象は22例で,PS良好群11例(PS 0/1:3/8例),PS不良群11例(PS 2/3/4:6/3/2例)だった。PS良好群と不良群の奏効率は9%と0%,病勢コントロール率は73%と18%,無増悪生存期間中央値は5.1か月[95%信頼区間(confidence interval: CI)1.5-8.7]と0.7か月(95%CI 0.3-1.0),全生存期間中央値は16か月(95%CI 8.8-24)と1.5か月(95%CI 0.7-2.4)であった。grade 3以上の有害事象は全体で18%に認められ,cetuximabで1例のinfusion reaction(grade 4)と,panitumumabで1例の間質性肺炎(grade 4)を認め,いずれも治療中止とした。治療関連死はなかった。PS良好例には実地臨床でも既報と同様の治療成績を示したが,PS 2以上には適応を慎重に検討する必要がある。