TY  - JOUR
A1  - Schulz, Martin S.
A1  - Wolf, Sebastian
A1  - Struck, Vera
A1  - Thomas, Niklas
A1  - Husman, Gabriele
A1  - Zeuzem, Stefan
A1  - Koch, Christine
A1  - Trojan, Jörg
A1  - Schnitzbauer, Andreas
A1  - Bechstein, Wolf Otto
A1  - Waidmann, Oliver
T1  - Anti-EGFR reintroduction and rechallenge in metastatic colorectal cancer (mCRC): a real-world analysis
T2  - Cancers
N2  - Background and Aims: In patients with Rat sarcoma proto-oncogene (RAS) wild-type metastatic colorectal cancer (mCRC), anti-epidermal growth factor receptor (EGFR) antibodies have been established in first- and further therapy lines. Due to limited treatment options upon disease progression, anti-EGFR re-exposure is increasingly employed in real-world oncology. The aim of this study was to assess clinical implementation and utility of anti-EGFR retreatment strategies in real-world mCRC patients. Methods: In this monocentric retrospective study, we included 524 patients with CRC and identified patients who received an anti-EGFR-based treatment as well as anti-EGFR rechallenge (progression on first-line anti-EGFR therapy) or reintroduction (discontinuation due to intolerance/toxicity/other). Results: In total, 143 patients received an anti-EGFR-based first- or second-line treatment, showing a similar overall survival (OS) compared to the non-anti-EGFR treatment group (38.3 vs. 39.6 months, p = 0.88). Thirty-three patients met the inclusion criteria for anti-EGFR re-exposure and were either assigned to rechallenge (n = 21) or reintroduction (n = 12) subgroups. The median FU after re-exposure was 45.8 months. Cetuximab and Panitumumab were used in 21 and 12 patients, respectively, and the main chemotherapy at re-exposure was FOLFIRI in 39.4%. Anti-EGFR re-exposure was associated with a distinct trend towards a better outcome (median OS 56.0 vs. 35.4 months, p = 0.06). In a subgroup comparison, reintroduction was associated with a higher OS and PFS in trend compared to the rechallenge (mOS 66 vs. 52.4, n.s., mPFS 7.33 vs. 3.68 months, n.s.). Conclusions: This retrospective study provides real-world evidence underscoring that anti-EGFR re-exposure strategies might benefit patients independently of the reason for prior discontinuation.
KW  - chemorefractory metastatic colorectal cancer
KW  - anti-EGFR therapy
KW  - re-exposure
KW  - rechallenge
KW  - reintroduction
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/69292
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-692929
SN  - 2072-6694
N1  - The APC were kindly funded by the Open-Access-Fund of the Goethe University Frankfurt am Main.
VL  - 14
IS  - 7, art. 1641
SP  - 1
EP  - 13
PB  - MDPI
CY  - Basel
ER  -