IRIS plus panitumumab for metastatic CRC
髙岡, 遠 徳島大学大学院医科学教育部（医学専攻）
Shimoyama, Rai Shonan Kamakura General Hospital
Kawamoto, Shunji Fukuoka Tokushukai Medical Center
Sakamoto, Kazuki Kishiwada Tokushukai Hospital
Goda, Fuminori Kagawa University Hospital
Negoro, Yuji Kochi Health Sciences center
Tsuji, Akihito Kobe City Medical Center General Hospital
Yoshizaki, Koji Sapporo Higashi Tokushukai Hospital
矢野, 弘美 Tokushima University
木村, 雅子 Tokushima University
Niitsu, Yoshiro Sapporo Medical University
Background Irinotecan plus S-1 (IRIS) is the only oral fluoropyrimidine-based regimen reported to be non-inferior to FOLFIRI and widely used in clinical practice for metastatic colorectal cancer (mCRC) patients. However, the combination of IRIS plus an anti-EGFR agent has not been evaluated previously. This study aimed to investigate the feasibility and efficacy of IRIS with panitumumab as second-line therapy for wild-type KRAS mCRC.
Methods Main inclusion criteria were patients with wild-type KRAS mCRC refractory to one prior chemotherapy regimen for mCRC, ECOG PS 0-2, and age ≥ 20 years. Patients received panitumumab (6mg/kg) and irinotecan (100mg/m2) on days 1 and 15 and S-1 (40-60 mg according to body surface area) twice daily for 2 weeks, repeated every 4 weeks. The primary endpoint was the feasibility of the therapy. The secondary endpoints were response rate (RR), progression-free survival (PFS), and overall survival (OS).
Results A total of 36 patients received protocol treatment in eight centers. Of these, 23 patients (63.9%) completed protocol treatment, demonstrating achievement of the primary endpoint. The most frequent grade 3/4 toxicities were diarrhea (16.7%), acne-like rash (13.9%), and neutropenia (11.1%). The overall RR was 33.3% (12/36). Of these 4 five underwent conversion surgery. Median PFS and OS were 9.5 months (95% CI 3.5-15.4 months) and 20.1 months (95% CI 16.7-23.2 months), respectively.
Conclusion IRIS plus panitumumab has an acceptable toxicity profile and a promising efficacy in patients with previously treated wild-type KRAS mCRC. Accordingly, this regimen can be an additional treatment option for second-line chemotherapy in wild-type KRAS mCRC.
Cancer Chemotherapy and Pharmacology
Springer Berlin Heidelberg
内容要旨・審査要旨 : LID201701051002.pdf
論文本文 : k2997_fulltext.pdf
本論文は, 著者Toshi Takaokaの学位論文として提出され, 学位審査・授与の対象となっている。
The final publication is available at link.springer.com.
LID201701051002.pdf 363 KB
k2997_fulltext.pdf 475 KB