Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2018, Vol. 40 ›› Issue (5): 660-666.doi: 10.3881/j.issn.1000-503X.10125

• Original Articles • Previous Articles     Next Articles

Efficacy and Prognostic Factors of Cetuximab Therapy in Treating KRAS or All RAS Wild-type Metastatic Colorectal Cancer

WU Xi1, DENG Bingbin2, BAI Chunmei1, ZHAO Lin1, CHENG Yuejuan1, LI Xiaoyuan1, LI Ningning1, ZHOU Jianfeng1()   

  1. 1 Department of Medical Oncology,PUMC Hospital,CAMS and PUMC,Beijing 100052,China
    2 Department of Radiotherapy and Oncology,the Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215000,China
  • Received:2017-10-26 Online:2018-10-30 Published:2018-11-07
  • Contact: Jianfeng ZHOU E-mail:ZhouJF@pumch.cn
  • Supported by:
    Supported by the CAMS Innovation Fund for Medical Sciences(2016-I2M-1-001)

Abstract:

Objective To explore the efficacy and prognostic factors of cetuximab therapy for KRAS or all RAS wild-type(WT)metastatic colorectal cancer(mCRC).Methods We screened mCRC patients receiving at least two cycles of cetuximb and chemotherapy from those with KRAS WT(before November 2013)or all-RAS-WT(after November 2013)in the Department of Medical Oncology,Peking Union Medical College Hospital from November 2007 to December 2016. The relationship between the clinicopathological characteristics and the efficacy was retrospectively analyzed.Results A total of 60 patients were included. For the 34 patients receiving cetuximab as first-line treatment,the objective response rate(ORR)was 55.9%,and the progression-free survival and overall survival(OS)was 10 and 24 months,respectively. All-RAS-WT mCRC had significantly lower risk of progression than those with KRAS-only-WT(P=0.012),and left-sided colorectal cancer had higher ORR than right-sided colon cancer(62.1% vs. 0,P=0.033)during the first-line treatment. The median OS of the eight patients continuing cetuximab beyond first-line progression was 35.0(95%CI:23.6-46.4)months.Conclusions The efficacy of cetuximab for left-sided colorectal cancer was better than for right-sided colon cancer,and patients with all-RAS-WT have lower risk of progression than those with KRAS-only-WT. Patients benefiting from first-line cetuximab and continuing cetuximab beyond progression survive longer.

Key words: metastatic colorectal cancer, RAS gene, cetuximab, efficacy, prognosis

CLC Number: