According to results presented at the 42nd annual meeting of the American Society of Clinical Oncology (ASCO), the addition of the targeted agent Erbitux® (cetuximab) to the chemotherapy regimen referred to as XELOX significantly improves anticancer responses and reduces cancer progression compared to XELOX alone when used as initial therapy in metastatic colorectal cancer.
Colorectal cancer is the second leading cause of cancer-related deaths in the U.S. Once the cancer has spread to distant sites in the body, it is referred to as metastatic cancer. At this stage, treatment is generally aimed at prolonging survival and improving quality of life.
Metastatic colorectal cancer remains virtually incurable. Treatment and current research is often aimed at improving duration of survival while maintaining quality of life for these patients. XELOX (capecitabine plus oxaliplatin) is an important treatment alternative to FOLFOX (5-fluorouracil, oxaliplatin, leucovorin) for some patients with colorectal cancer.
Erbitux is a type of targeted therapy called a monoclonal antibody. It works by binding to a protein receptor located on many cancer cells called the epidermal growth factor receptor (EGFR).
Erbitux is currently approved, in combination with radiation therapy, for the treatment of locally or regionally advanced head and neck cancer, or as a single agent in the treatment of advanced, EGFR-expressing head and neck cancer that has not responded to prior platinum-based therapies. It is also approved for treatment with Camptosar in patients with EGFR-expressing, metastatic colorectal cancer that has not responded to prior Camptosar-based therapies. As well, Erbitux is approvred as a single agent in EGFR-expressing, advanced colorectal cancer in patients who are ineligible for Camptosar-based therapies.
Erbitux continues to be evaluated in several clinical trials in the treatment of various cancers.
Researchers from Switzerland recently conducted a clinical trial that included 74 patients with untreated metastatic colorectal cancer who were treated with XELOX alone or Erbitux plus XELOX and were directly compared.
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- At nine weeks partial regression of measurable cancer (partial response) was achieved in 57% of patients treated with Erbitux/XELOX, compared with only 27% of patients treated with XELOX alone.
- At nine weeks stable disease was achieved in 30% of patients treated with Erbitux/XELOX, compared with 56% of patients treated with XELOX alone.
- At 18 weeks partial responses were achieved in 51% of patients treated with Erbitux/XELOX, compared with 30% of patients treated with XELOX alone.
- At 18 weeks stable disease was achieved in 16% of patients treated with Erbitux/XELOX, compared with 14% of patients treated with XELOX alone.
- At 18 weeks cancer progression occurred in only 14% of patients treated with Erbitux/XELOX, compared with 24% of patients treated with XELOX alone.
- Adverse events were comparable in both treatment groups.
The researchers concluded that the addition of Erbitux to XELOX improves responses and delays cancer progression when used as initial therapy in metastatic colorectal cancer. Longer follow-up is planned to determine if these results lead to improved long-term outcomes, including survival, in this group of patients.
Reference: The Impact of Cetuximab on the Capecitabine Plus Oxaliplatin Combination in First-Line Treatment of Metastatic Colorectal Cancer (MCC): A Randomized Phase II Trial of the Swiss Group for Clinical Cancer Research SAKK (Trial SAKK 41/04). Proceedings from the 42nd annual meeting of the American Society of Clinical Oncology. June 2006. Atlanta, GA.
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