Patients whose colorectal cancer has already gotten worse on initial FOLFOX therapy do better when Erbitux® (cetuximab) is added to Camptosar® (irinotecan) during their second-line treatment.
The ERBITUX Plus Irinotecan for Metastatic Colorectal Cancer (EPIC) study randomly assigned 1,300 patients with colorectal cancer who had to stop their initial FOLFOX treatment when their cancer got worse or side effects became intolerable to:
- Camptosar (irinotecan) alone
- Camptosar plus Erbitux (cetuximab)
While the study did not meet its primary objective — increasing overall survival in the combination arm, both response rates and rates of progression-free survival were higher in the Erbitux/Camptosar arm.
Since almost half of patients in the non-Erbitux arm of the trial eventually received some form of Erbitux treatment, it is possible that these subsequent therapies impacted overall survival results.
Comparison of the two arms revealed:
- Overall survival: 10.7 months for the combination, 10 months for irinotecan alone.
- Progression-free survival: 4.0 months for combination, 2.6 months for irinotecan.
- Response rate: 16.4 percent for cetuximab and irinotecan, 4.2 percent for irinotecan alone.
In addition, quality of life measures, including overall health status and physical, emotional, and cognitive functioning were better in the group treated with both Erbitux and Camptosar.
Led by Alberto F. Sobrero MD, the research team concluded,
Cetuximab and irinotecan improved progression-free survival and response rate, and resulted in better quality of life, versus irinotecan alone. Overall survival was similar between study groups, possibly influenced by the large number of patients in the irinotecan arm who received cetuximab and irinotecan post study.
SOURCE: Sobrero et al. Journal of Clinical Oncology, published online ahead of print Apr 7 2008.
Disclosure: C3 has accepted funding for projects and educational programs from Bristol Myers Squibb and ImClone Systems in the form of unrestricted educational grants. C3 has ultimate authority over website content.
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