Predictive factors for the efficacy of cetuximab plus chemotherapy as salvage therapy in metastatic gastric cancer patients

• Published in: Cancer chemotherapy and pharmacology Vol. 65; no. 3; pp. 579 - 587
• Main Authors: Park, Sook Ryun, Kook, Myeong-Cherl, Choi, Il Ju, Kim, Chan Gyoo, Lee, Jong Yeul, Cho, Soo-Jeong, Kim, Young-Woo, Ryu, Keun Won, Lee, Jun Ho, Lee, Jong Seok, Park, Young-Iee, Kim, Noe Kyeong
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Berlin/Heidelberg : Springer-Verlag 01.02.2010; Springer-Verlag; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal - adverse effects; Antibodies, Monoclonal, Humanized; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Camptothecin - administration & dosage; Camptothecin - adverse effects; Camptothecin - analogs & derivatives; Cancer Research; Cetuximab; Dermatology; DNA Mutational Analysis; Exanthema - chemically induced; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Mutation; Neoplasm Metastasis; Oncology; Original Article; Pharmacology. Drug treatments; Pharmacology/Toxicology; Predictive Value of Tests; Prognosis; Proto-Oncogene Proteins - genetics; Proto-Oncogene Proteins p21(ras); ras Proteins - genetics; Retrospective Studies; Salvage Therapy; Skin involvement in other diseases. Miscellaneous. General aspects; Stomach Neoplasms - drug therapy; Stomach Neoplasms - genetics; Stomach Neoplasms - pathology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Survival Analysis; Treatment Outcome; Tumors; Chemotherapy; K-ras; Predictor; Cetuximab; Gastric cancer; Skin rash; Performance status; Antineoplastic agent; Performance evaluation; Skin disease; Monoclonal antibody; Metastasis; Stomach cancer; Epidermal growth factor receptor; K ras Gene; Advanced stage; Protooncogene; Gastric disease; Human; Treatment efficiency; Patient; Malignant tumor; Treatment; C-Onc gene; Digestive diseases; Skin; Salvage treatment; Erythema; Predictive factor; Onc gene; Performance; Cancer
• ISSN: 0344-5704; 1432-0843
• DOI: 10.1007/s00280-009-1067-9

Purpose We performed a retrospective study to evaluate the efficacy of cetuximab plus chemotherapy in metastatic gastric cancer (MGC) patients previously treated with chemotherapy and to investigate potential predictors of treatment efficacy in those patients. Methods Thirty-two patients with MGC were included in this study. Cetuximab was delivered, often combined with irinotecan-based chemotherapy. Thirty patients were analyzed for K-ras mutations via direct sequencing of the tumor DNA. Results Patients were heavily pretreated with a median number of three previous lines of palliative chemotherapy (56% of the patients were refractory to all of the following drugs: fluoropyrimidines, cisplatin, irinotecan, oxaliplatin, and docetaxel) and 53% of the patients displayed poor performance status. Of 28 response-assessable patients, the overall response rate to cetuximab plus chemotherapy was 3.6% [95% confidence interval (CI) 0-10.5%] and the disease control rate was 28.6%. The median progression-free survival (PFS) was 1.7 months (95% CI 1.3-2.1 months), and the median overall survival (OS) was 3.2 months (95% CI 1.4-5.0 months). Multivariate analyses revealed that skin rash and performance status were significantly associated with PFS and OS. The presence of a K-ras mutation (13.3%) was not associated with either PFS or OS. Conclusion Our study suggests that MGC patients with good performance status and skin rash benefit most from salvage cetuximab combined with chemotherapy, even in heavily pretreated status.