The role of cetuximab in pre-treated refractory patients with metastatic colorectal cancer: Outcome study in clinical practice

We carried out a multicentric retrospective study on cetuximab + chemotherapy in pre-treated refractory patients outside clinical protocols, by registering the main clinical and pathological parameters. We evaluated 144 pre-treated patients. Cetuximab was administered usually in combination with irinotecan (93.8%). A 45% disease control rate (complete plus partial responses plus stable disease) was obtained in 55 patients and was related to absence of weight loss (p < 0.0001) and high grade (>= 2) skin toxicity (p < 0.0001). Median time to progression (TTP) was 4 months (95%CI 2.7-5.3) and median overall survival (OS) was 11.8 months (95%CI 8.5-15.1). Performance status <= 1, no weight loss and high grade (>= 2) skin toxicity were related both to a longer TTP (p=0.035, p=0.035, p=0.0017) and OS (p < 0.0001, p < 0.0001, p=0.006). According to multivariate analysis, the absence of weight loss was related to longer TTP (HR 0.331, p=0.004) and OS (HR 0.176, p < 0.0001), and EGFR over-expression (3+) to longer TTP (HR 0.402, p=0.020).