Chemotherapy with Erbitux Converts Unresectable Liver Mets to Allow Surgery

Update from the 2009 Gastrointestinal Cancer Symposium

Combining chemotherapy with Erbitux® (cetuximab) can effectively shrink tumors and enable surgeons to remove formerly unresectable colorectal cancer that has spread to the liver, offering potentially curative treatment.

German doctors randomized patients with unresectable liver metastases to treatment with either FOLFOX with Erbitux or FOLFIRI with Erbitux.  Patients in the study either had five or more tumors in their liver or surgery to remove liver tumors was considered to be technically impossible.

After initial treatment with the combined chemotherapy and Erbitux regimens, 75 percent of patients had tumors shrink, 40 percent were able to have surgery to remove liver metatases, and 35 percent had all visible signs of liver tumor removed.

Median time before surgery became possible was five months.

Thirty-two percent of the patients whose tumors had been considered technically unresectable were able to have all signs of cancer in their liver removed (R0 resection). For those patients with five or more liver mets, 40 percent had an R0 resection.

The most common serious, grade 3 or 4 side effects before surgery were skin rash (33 percent), neutropenia (23 percent), diarrhea (14 percent), and neuropathy (10 percent).

The research team concluded,

The combination of cetuximab with standard chemotherapy has demonstrated high activity (79% in KRAS wild type patients) and an encouraging rate of liver resection.

SOURCE: Gruenberger et al., 2009 GI Symposium, Abstract 296.

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