No Survival Benefit With Cetuximab in Colorectal Cancer

However, patients with normal platelet counts benefit from intermittent chemotherapy

MONDAY, June 6 (HealthDay News) -- The addition of cetuximab to standard chemotherapy for the treatment of advanced colorectal cancer does not improve progression-free survival (PFS) or overall survival (OS), according to a study published online June 4 in The Lancet.

Timothy S. Maughan, M.D., of Cardiff University in the United Kingdom, and colleagues randomized patients who were fit for but had not received previous chemotherapy for advanced colorectal cancer to oxaliplatin and fluoropyrimidine chemotherapy (arm A), the same combination plus cetuximab (arm B), or intermittent chemotherapy (arm C). The investigators randomly assigned 1,630 to treatment arm A (815) and treatment arm B (815), and described the results of this comparison. The comparison of arms A and C was described in a companion paper. The investigators found that cetuximab had no significant benefit on PFS or OS. In addition, subgroup analysis revealed that patients with or without the KRAS wild-type gene did not have significantly improved PFS or OS.

In the companion paper, Richard A. Adams, M.D., of Cardiff University, and colleagues found that intermittent chemotherapy did not increase or significantly decrease survival. However, further analysis revealed that a raised platelet count among those undergoing intermittent chemotherapy was associated with a five-month reduction in survival and impaired quality of life, while intermittent chemotherapy among patients with normal platelet counts was associated with improved quality of life with similar survival.

"There seems to be a large subpopulation of patients for whom intermittent therapy provides similar survival benefit and the results of this trial provide a basis for discussion of options between patients and clinicians," Adams and colleagues said in a statement.

The first study was funded in part by Merck KGaA; several authors disclosed financial relationships with Merck and other pharmaceutical companies. Multiple authors from the second study also disclosed financial relationships with various pharmaceutical companies.

Abstract - Maughan
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Abstract - Adams
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