ABSTRACT
Hong Kong Med J 2010;16:207–12 | Number 3, June 2010
ORIGINAL ARTICLE
Clinical predictors of response to cetuximab-chemotherapy in metastatic colorectal cancer
Ada TW Ma, Brigette BY Ma, Kenny IK Lei, Frankie KF Mo, Anthony TC Chan
State Key Laboratory in Oncology in South China, Sir YK Pao Centre for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute, The Chinese University of Hong Kong, Shatin, Hong Kong
OBJECTIVE. To identify clinical markers to predict which patients with advanced colorectal cancers are likely to benefit from cetuximab-chemotherapy.
DESIGN. Retrospective review.
SETTING. Oncology unit in a university teaching hospital in Hong Kong.
PATIENTS. A total of 102 patients with metastatic colorectal cancer treated with cetuximab-chemotherapy.
MAIN OUTCOME MEASURES. Correlation of multiple potential clinical predictive factors with tumour response to cetuximab-chemotherapy.
RESULTS. The objective response rates to cetuximab plus chemotherapy were 53% in patients receiving first-line treatment and 17% in previously treated patients. The univariate analysis indicated that fewer prior lines of chemotherapy (odds ratio=0.36; 95% confidence interval, 0.21-0.63; P<0.01) and development of cetuximab-related grade 3 rash (5.52; 1.62-18.76; P<0.01) were associated with significantly higher response rates. Multivariate analysis confirmed the independent predictive value of the number of prior chemotherapy regimens (odds ratio=0.37; 95% confidence interval, 0.20-0.69; P<0.01) and grade 3 rash (4.65; 1.21-19.29; P=0.03).
CONCLUSIONS. In this cohort of Chinese patients with advanced colorectal cancer, the presence of grade 3 rash and the number of prior chemotherapy regimens were independent predictors of response to cetuximab-chemotherapy. The utility of these clinical markers in clinical practice should be further evaluated together with established biomarkers.
Key words: Antibodies, monoclonal; Colorectal neoplasms; Exanthema; Neoplasm metastasis; Receptor, epidermal growth factor
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