Anti-EGFR Reintroduction and Rechallenge in Metastatic Colorectal Cancer (mCRC): A Real-World Analysis
Background and Aims: In patients with <i>Rat sarcoma proto-oncogene</i> (<i>RAS</i>) wild-type metastatic colorectal cancer (mCRC), anti-epidermal growth factor receptor (EGFR) antibodies have been established in first- and further therapy lines. Due to limited treatment opti...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/7/1641 |
| _version_ | 1797440217818333184 |
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| author | Martin S. Schulz Sebastian Wolf Vera Struck Niklas Thomas Gabriele Husman Stefan Zeuzem Christine Koch Jörg Trojan Andreas Anton Schnitzbauer Wolf Otto Bechstein Oliver Waidmann |
| author_facet | Martin S. Schulz Sebastian Wolf Vera Struck Niklas Thomas Gabriele Husman Stefan Zeuzem Christine Koch Jörg Trojan Andreas Anton Schnitzbauer Wolf Otto Bechstein Oliver Waidmann |
| author_sort | Martin S. Schulz |
| collection | DOAJ |
| description | Background and Aims: In patients with <i>Rat sarcoma proto-oncogene</i> (<i>RAS</i>) wild-type metastatic colorectal cancer (mCRC), anti-epidermal growth factor receptor (EGFR) antibodies have been established in first- and further therapy lines. Due to limited treatment options upon disease progression, anti-EGFR re-exposure is increasingly employed in real-world oncology. The aim of this study was to assess clinical implementation and utility of anti-EGFR retreatment strategies in real-world mCRC patients. Methods: In this monocentric retrospective study, we included 524 patients with CRC and identified patients who received an anti-EGFR-based treatment as well as anti-EGFR rechallenge (progression on first-line anti-EGFR therapy) or reintroduction (discontinuation due to intolerance/toxicity/other). Results: In total, 143 patients received an anti-EGFR-based first- or second-line treatment, showing a similar overall survival (OS) compared to the non-anti-EGFR treatment group (38.3 vs. 39.6 months, <i>p</i> = 0.88). Thirty-three patients met the inclusion criteria for anti-EGFR re-exposure and were either assigned to rechallenge (<i>n</i> = 21) or reintroduction (<i>n</i> = 12) subgroups. The median FU after re-exposure was 45.8 months. Cetuximab and Panitumumab were used in 21 and 12 patients, respectively, and the main chemotherapy at re-exposure was FOLFIRI in 39.4%. Anti-EGFR re-exposure was associated with a distinct trend towards a better outcome (median OS 56.0 vs. 35.4 months, <i>p</i> = 0.06). In a subgroup comparison, reintroduction was associated with a higher OS and PFS in trend compared to the rechallenge (mOS 66 vs. 52.4, n.s., mPFS 7.33 vs. 3.68 months, n.s.). Conclusions: This retrospective study provides real-world evidence underscoring that anti-EGFR re-exposure strategies might benefit patients independently of the reason for prior discontinuation. |
| first_indexed | 2024-03-09T12:04:59Z |
| format | Article |
| id | doaj.art-b0b818c7cf6446288825fbea36b6f16b |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T12:04:59Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-b0b818c7cf6446288825fbea36b6f16b2023-11-30T22:59:57ZengMDPI AGCancers2072-66942022-03-01147164110.3390/cancers14071641Anti-EGFR Reintroduction and Rechallenge in Metastatic Colorectal Cancer (mCRC): A Real-World AnalysisMartin S. Schulz0Sebastian Wolf1Vera Struck2Niklas Thomas3Gabriele Husman4Stefan Zeuzem5Christine Koch6Jörg Trojan7Andreas Anton Schnitzbauer8Wolf Otto Bechstein9Oliver Waidmann10Department of Internal Medicine I, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, GermanyDepartment of Internal Medicine II, University Hospital Frankfurt, Goethe University, 0590 Frankfurt, GermanyDepartment of Internal Medicine I, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, GermanyDepartment of Internal Medicine I, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, GermanyTumor Documentation, University Cancer Center, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, GermanyDepartment of Internal Medicine I, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, GermanyDepartment of Internal Medicine I, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, GermanyDepartment of Internal Medicine I, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, GermanyDepartment of General and Visceral Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, GermanyDepartment of General and Visceral Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, GermanyDepartment of Internal Medicine I, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, GermanyBackground and Aims: In patients with <i>Rat sarcoma proto-oncogene</i> (<i>RAS</i>) wild-type metastatic colorectal cancer (mCRC), anti-epidermal growth factor receptor (EGFR) antibodies have been established in first- and further therapy lines. Due to limited treatment options upon disease progression, anti-EGFR re-exposure is increasingly employed in real-world oncology. The aim of this study was to assess clinical implementation and utility of anti-EGFR retreatment strategies in real-world mCRC patients. Methods: In this monocentric retrospective study, we included 524 patients with CRC and identified patients who received an anti-EGFR-based treatment as well as anti-EGFR rechallenge (progression on first-line anti-EGFR therapy) or reintroduction (discontinuation due to intolerance/toxicity/other). Results: In total, 143 patients received an anti-EGFR-based first- or second-line treatment, showing a similar overall survival (OS) compared to the non-anti-EGFR treatment group (38.3 vs. 39.6 months, <i>p</i> = 0.88). Thirty-three patients met the inclusion criteria for anti-EGFR re-exposure and were either assigned to rechallenge (<i>n</i> = 21) or reintroduction (<i>n</i> = 12) subgroups. The median FU after re-exposure was 45.8 months. Cetuximab and Panitumumab were used in 21 and 12 patients, respectively, and the main chemotherapy at re-exposure was FOLFIRI in 39.4%. Anti-EGFR re-exposure was associated with a distinct trend towards a better outcome (median OS 56.0 vs. 35.4 months, <i>p</i> = 0.06). In a subgroup comparison, reintroduction was associated with a higher OS and PFS in trend compared to the rechallenge (mOS 66 vs. 52.4, n.s., mPFS 7.33 vs. 3.68 months, n.s.). Conclusions: This retrospective study provides real-world evidence underscoring that anti-EGFR re-exposure strategies might benefit patients independently of the reason for prior discontinuation.https://www.mdpi.com/2072-6694/14/7/1641chemorefractory metastatic colorectal canceranti-EGFR therapyre-exposurerechallengereintroduction |
| spellingShingle | Martin S. Schulz Sebastian Wolf Vera Struck Niklas Thomas Gabriele Husman Stefan Zeuzem Christine Koch Jörg Trojan Andreas Anton Schnitzbauer Wolf Otto Bechstein Oliver Waidmann Anti-EGFR Reintroduction and Rechallenge in Metastatic Colorectal Cancer (mCRC): A Real-World Analysis Cancers chemorefractory metastatic colorectal cancer anti-EGFR therapy re-exposure rechallenge reintroduction |
| title | Anti-EGFR Reintroduction and Rechallenge in Metastatic Colorectal Cancer (mCRC): A Real-World Analysis |
| title_full | Anti-EGFR Reintroduction and Rechallenge in Metastatic Colorectal Cancer (mCRC): A Real-World Analysis |
| title_fullStr | Anti-EGFR Reintroduction and Rechallenge in Metastatic Colorectal Cancer (mCRC): A Real-World Analysis |
| title_full_unstemmed | Anti-EGFR Reintroduction and Rechallenge in Metastatic Colorectal Cancer (mCRC): A Real-World Analysis |
| title_short | Anti-EGFR Reintroduction and Rechallenge in Metastatic Colorectal Cancer (mCRC): A Real-World Analysis |
| title_sort | anti egfr reintroduction and rechallenge in metastatic colorectal cancer mcrc a real world analysis |
| topic | chemorefractory metastatic colorectal cancer anti-EGFR therapy re-exposure rechallenge reintroduction |
| url | https://www.mdpi.com/2072-6694/14/7/1641 |
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