New recommendations issued for use of cetuximab in colon cancer therapy

Jul 16, 2010

In a report published in the July 2010 issue of the American Society for Clinical Oncology Post, new recommendations on the use of the drug cetuximab have been issued after officials halted enrollment in a phase III clinical trial in patients with spread of colon cancer into regional lymph nodes whose tumors had been surgically removed.

Based on earlier studies, cetuximab is now indicated for treatment of patients with advanced whose tumors do not have a mutation in the KRAS gene. KRAS is one of a series of genes along a pathway that can lead tumors cells to grow, divide and evade signals that shut the cells down causing their death. Based on the results in advanced disease, researchers had hoped to see similar benefits when cetuximab was added to a standard chemotherapy regimen in earlier stages of colon cancer. However, ongoing analysis during the clinical trial found that patients receiving the combination therapy had no significant improvement in survival compared to standard therapy.

Cetuximab is a monoclonal antibody that inhibits epidermal (EGFR) - a cell signaling pathway that contributes to . The drug is given by intravenous infusion for treatment of metastatic colorectal cancer and . Previously, researchers found that patients with a mutated KRAS gene - about 40 percent of those with metastatic colon cancer - do not respond to the EGFR inhibitors currently in use.

However, the genetic test for KRAS mutation was not standard until this trial was well underway. Patients enrolled before KRAS testing were segmented from those in the rest of the study and analyzed separately, said Richard Goldberg, MD, chief of the division of hematology/oncology at the UNC-Chapel Hill School of Medicine, who presented the results for this group of patients.

"We expected that patients with the genetic mutation would not respond to cetuximab, and that is what we found," said Goldberg, who is also physician-in-chief of the N.C. Cancer Hospital.

"However, even the patients in the study whose tumors did not harbor the KRAS mutation did not benefit significantly from the combination therapy and the standard treatment proved to have the best results. We also found that the was more toxic and the side effects of treatment - especially in older patients - negatively impacted their ability to complete the standard treatment," he added.

The researchers issued a recommendation that should not be used in patients with stage III . It remains a valuable tool in treating patients with advanced colorectal cancers whose tumors do not harbor a KRAS mutation and can either be administered as a single agent or with chemotherapy.

Explore further: Survival differences seen for advanced-stage laryngeal cancer

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Survival differences seen for advanced-stage laryngeal cancer

20 hours ago

The five-year survival rate for advanced-stage laryngeal cancer was higher than national levels in a small study at a single academic center performing a high rate of surgical therapy, including a total laryngectomy (removal ...

Gene test aids cancer profile

Nov 27, 2014

The first round of chemotherapy did little to suppress Ron Bose's leukemia. The second round, with 10 times the dose, knocked the proliferating blast cells down, but only by half.

Hospital volume not linked to costs of cancer surgery

Nov 26, 2014

(HealthDay)—Hospital surgical volume does not appear to correlate with Medicare payments for cancer surgery, according to research published online Nov. 24 in the Journal of Clinical Oncology.

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.