Anti-EGFR (cetuximab) combined with irinotecan for treatment of elderly patients with metastatic colorectal cancer (mCRC)

Abdelwahab, Sherif; Azmy, A.; Abdel-Aziz, H; Salim, Hogir; Mahmoud, Amir

doi:10.1007/s00432-012-1229-8

Cited by 17 publications

(6 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These results appear to compare favourably with other studies in elderly patients treated with bevacizumab plus chemotherapy (Puthillath et al , 2009; Vrdoljak et al , 2011; Wong et al , 2011; Rosati et al , 2013) or cetuximab with or without chemotherapy (Sastre et al , 2011; Abdelwahab et al , 2012; Sastre et al , 2012). Furthermore, our survival data appear to compare well with those from studies in which elderly patients were treated with chemotherapy alone, although such comparisons are made with caution as patient characteristics, inclusion criteria and other variables may differ between trials (Sastre et al , 2009; Rosati et al , 2010; Berretta et al , 2011; Benavides et al , 2012).…”

Section: Discussionsupporting

confidence: 72%

First-line bevacizumab and capecitabine–oxaliplatin in elderly patients with mCRC: GEMCAD phase II BECOX study

et al. 2014

View full text Add to dashboard Cite

Background:Subgroup analyses of clinical studies suggest that bevacizumab plus XELOX is effective and tolerable in elderly patients with metastatic colorectal cancer (mCRC). The prospective BECOX study examined the efficacy and safety of bevacizumab plus XELOX, followed by bevacizumab plus capecitabine in elderly patients with mCRC.Methods:Patients aged ⩾70 years with Eastern Cooperative Oncology Group performance status 0 out of 1 and confirmed mCRC were included. Patients received bevacizumab 7.5 mg kg−1 and oxaliplatin 130 mg m−2 on day 1, plus capecitabine 1000 mg m−2 bid orally on days 1–14 every 21 days; oxaliplatin was discontinued after 6 cycles. The primary end point was time to progression (TTP).Results:The intent-to-treat population comprised 68 patients (65% male, median age 76 years). Median TTP was 11.1 months; median overall survival was 20.4 months; overall response rate was 46%. Grade 3 or 4 adverse events included diarrhoea (18%) and asthenia (16%). Grade 3 or 4 adverse events of special interest for bevacizumab included deep-vein thrombosis (6%) and pulmonary embolism (4%).Conclusions:Bevacizumab plus XELOX was effective and well tolerated in elderly patients in the BECOX study. The adverse-event profile was similar to previous reports; no new safety concerns were identified. Fit elderly patients with mCRC should be considered for treatment with bevacizumab plus XELOX.

show abstract

Section: Discussionsupporting

confidence: 72%

First-line bevacizumab and capecitabine–oxaliplatin in elderly patients with mCRC: GEMCAD phase II BECOX study

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Limited numbers of elderly patients were included in the randomized studies which preceded the approval of anti-EGFR antibodies for the treatment of mCRC. Several European studies have shown these agents to have acceptable tolerance and efficacy when used in older adults, both as a single agent and in combination with chemotherapy 10,12,14 . To our knowledge, this is the first study to evaluate the patterns of use and tolerance of anti-EGFR agents among older patients in an academic center in the United States.…”

Section: Discussionmentioning

confidence: 99%

“…The study demonstrated similar toxicity and efficacy with the combination of cetuximab and irinotecan in older and younger patient cohorts 11 . The Spanish Group for Digestive Tumors Therapy (TTD) studied cetuximab as a single agent and in combination with irinotecan or capecitabine in the older population and demonstrated a similar toxicity profile to that seen among younger patients 12–14 . We sought to evaluate the use of anti-EGFR antibodies among older patients with mCRC treated at an academic center in the United States.…”

Section: Introductionmentioning

confidence: 99%

Patterns of Use and Tolerance of Anti–Epidermal Growth Factor Receptor Antibodies in Older Adults With Metastatic Colorectal Cancer

Dotan

Devarajan

D'Silva

et al. 2014

Clinical Colorectal Cancer

View full text Add to dashboard Cite

Introduction Limited data are available regarding the tolerance of anti-epidermal growth factor receptor (EGFR) antibodies among elderly metastatic colorectal cancer (mCRC) patients. We retrospectively reviewed our experience of treating elderly mCRC patients with these agents between 2004 and 2011. Methods mCRC patients ≥65 years old treated with anti-EGFR agents were included in this analysis. We recorded demographic and disease characteristics, treatment regimen and duration, KRAS status, and overall survival. Toxicity evaluation included common hematologic and non-hematologic toxicities seen with these agents. Results 117 patients were included with median age at treatment initiation of 73 years (65–86), 59% male gender, 82% colon primary, and 51% with metastatic disease at presentation. Median time on anti-EGFR treatment was 2.4 months. Older age at treatment initiation was associated with use of anti-EGFR antibody as monotherapy versus combination (p=0.0009). Worse performance status at treatment initiation was associated with a shorter overall survival (p=0.013) and shorter treatment duration (p=0.01). The incidence of hematologic/non-hematologic grade 3 or higher toxicity was 36% and 15% respectively. No association was found between age and presence of ≥ grade 3 toxicities. Longer treatment duration and better performance status at treatment initiation were the only factors associated with higher incidence of grade 3 toxicity. Conclusions Our data demonstrate that anti-EGFR antibodies can be used among older mCRC patients, with toxicity profiles similar to those reported in large phase III studies of younger patients. Advanced age was associated with receipt of anti-EGFR agents as monotherapy, but did not impact treatment outcomes in this population.

show abstract

“…The response rate in this subgroup was 48.3% and the PFS 8.4 months [ 34 ]. Finally, in the previously-treated setting, cetuximab in combination with irinotecan was found to be safe in 49 patients over 65 years old and resulted in a median PFS of four months and OS of seven months [ 35 ].…”

Section: Agents That Target the Epidermal Growth Factor Receptormentioning

confidence: 99%

The Place of Targeted Agents in the Treatment of Elderly Patients with Metastatic Colorectal Cancer

Matikas

Asimakopoulou

Georgoulias

et al. 2015

Cancers

View full text Add to dashboard Cite

Despite the high prevalence of colorectal cancer in a continuously aging population and the substantial advances in the treatment of metastatic disease during the past decade, the treatment of elderly patients with advanced, unresectable or metastatic colorectal cancer is a clearly unmet need. Since older patients are under-represented or even excluded from randomized trials, the evidence that oncologists use as guidance is weak. However, small prospective studies, pooled analyses and observational studies show that combination approaches are safe, efficacious and feasible in the geriatric population with metastatic colorectal cancer. The use of biologic agents targeting angiogenesis and the epidermal growth factor receptor, which have been shown to clearly improve outcomes in multiple prospective trials in patients with advanced colorectal cancer, is a vital component of the aforementioned combination approaches. Herein, we review all available data concerning the management of elderly patients with these agents and underscore the differences between this age subgroup and younger patients.

show abstract

Anti-EGFR (cetuximab) combined with irinotecan for treatment of elderly patients with metastatic colorectal cancer (mCRC)

Abstract: Cetuximab combined with irinotecan when administered biweekly is safe and effective for treatment of pretreated elderly patients with mCRC.

Cited by 17 publications

References 31 publications

First-line bevacizumab and capecitabine–oxaliplatin in elderly patients with mCRC: GEMCAD phase II BECOX study

First-line bevacizumab and capecitabine–oxaliplatin in elderly patients with mCRC: GEMCAD phase II BECOX study

Patterns of Use and Tolerance of Anti–Epidermal Growth Factor Receptor Antibodies in Older Adults With Metastatic Colorectal Cancer

The Place of Targeted Agents in the Treatment of Elderly Patients with Metastatic Colorectal Cancer

Contact Info

Product

Resources

About