ABSTRACT
In heavily pre-treated patients with metastatic colorectal cancer (mCRC), further chemotherapy has not demonstrated efficacy. Panitumumab is indicated as monotherapy treatment of epidermal growth factor receptor (EGFR)-expressing, Kirsten (K)-RAS wild-type metastatic colorectal cancer after failure of fluoropyrimidine-, oxaliplatin- and irinotecan-containing regimens. However, panitumumab has not been specifically evaluated in patients following failure of a bevacizumab-containing regimen. One female and two male patients with mCRC presented with tumour recurrence in the para-aortic lymph nodes, the liver and the local presacral lymph nodes, respectively. The patients were confirmed to have K-RAS wild-type-expressing tumours. Following the failure of bevacizumab-containing chemotherapy regimens, all three patients received panitumumab monotherapy. Panitumumab was well-tolerated. All the patients responded to panitumumab monotherapy in this late-stage setting. This patient series suggests that panitumumab can improve patient outcomes and may be an alternative treatment option in patients with mCRC who have received prior treatment with bevacizumab plus chemotherapy.
Subject(s)
Antibodies, Monoclonal/therapeutic use , Antineoplastic Agents/therapeutic use , Colorectal Neoplasms/drug therapy , Colorectal Neoplasms/pathology , Aged , Ascites/complications , Ascites/diagnostic imaging , Colorectal Neoplasms/complications , Colorectal Neoplasms/diagnostic imaging , Disease Progression , Female , Humans , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/secondary , Male , Middle Aged , Neoplasm Metastasis , Panitumumab , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
BACKGROUND: Pancreatic cancer remains a disease of high mortality and one of the most frustrating, resistant solid neoplasms to treat. The aim of this study was to evaluate a biweekly gemcitabine plus daily erlotinib regimen in patients with advanced (stage III-IV) pancreatic cancer in terms of overall survival and time to progression of the disease. The secondary aim was to record treatment related toxicities. PATIENTS AND METHODS: Twenty-seven patients with metastatic non-operable pancreatic adenocarcinoma, stage III-IV, consented to receive chemotherapy with gemcitabine and erlotinib. Patients received first-line treatment with gemcitabine (2 g/m(2) via 90 min i.v. infusion every two weeks) and 100 mg erlotinib per os every day, for at least 12 consecutive courses (6 cycles). Treatment was discontinued at disease progression and/or serious toxicity. RESULTS: The objective response rate was 25.9% (95% confidence interval [CI]: 11.1-46.3%) and the stable disease rate was 59.3% (95% CI: 38.8-77.6%). The one-year overall survival was 20%. The median overall survival and time to progression at the time of assessment was 7.5 months (95% CI: 3.6-42 months) and 5.5 months (95% CI: 1.5-10 months), respectively. Overall survival and time to progression were related to response (p<0.001), while time to progression was further related to disease stage (p=0.011). No grade 4 haematological or non-haematological toxicities were observed. CONCLUSION: The biweekly regimen of gemcitabine plus erlotinib has similar toxicity and efficacy to weekly administration, presenting both patients and hospital resource departments with a clearly more convenient therapy alternative.
