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Rash After Cetuximab Is Indicator of Clinical Benefit

Rash tied to better outcomes in patients with NSCLC receiving chemotherapy plus cetuximab

MONDAY, Dec. 20 (HealthDay News) -- An acne-like rash among patients with non-small-cell lung cancer (NSCLC) undergoing treatment with cisplatin and vinorelbine plus cetuximab is associated with improved outcomes, according to research published online Dec. 20 in The Lancet Oncology.

In a subgroup analysis of the First-Line Erbitux in Lung Cancer study, Ulrich Gatzemeier, M.D., of the Hospital Grosshansdorf in Hamburg, Germany, and colleagues evaluated whether the development of an acne-like rash in the first 21 days of treatment (first-cycle rash) with cisplatin and vinorelbine plus cetuximab (518 subjects) and cisplatin and vinorelbine alone (540 subjects) was associated with clinical outcome, on the basis of patients in the intention-to-treat population alive on day 21.

The investigators found that 290 patients in the chemotherapy plus cetuximab group developed first-cycle rash. Patients in the chemotherapy plus cetuximab group with first-cycle rash experienced significantly prolonged overall survival (15 versus 8.8 months), improved response rates (44.8 versus 32 percent), and progression-free survival (5.4 versus 4.3 months), compared with patients in the same treatment group without first-cycle rash. The significant overall survival benefit for patients with first-cycle rash as compared with those without rash was seen in all histology subgroups, including those with adenocarcinoma (16.9 versus 9.3 months), squamous-cell carcinoma (13.2 versus 8.1 months), and carcinomas of other histology (12.6 versus 6.9 months). Overall survival in patients getting cetuximab who did not have a first-cycle rash was similar to those who received chemotherapy only.

"First-cycle rash was associated with a better outcome in patients with advanced NSCLC who received cisplatin and vinorelbine plus cetuximab as a first-line treatment. First-cycle rash might be a surrogate clinical marker that could be used to tailor cetuximab treatment for advanced NSCLC to those patients who would be most likely to derive a significant benefit," the authors write.

The study was funded by Merck; several authors disclosed financial relationships with Merck and other pharmaceutical companies.

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