Metastatic Colorectal Cancer Treated with FOLFOX + Cetuximab in Long Term Use Protocol. Complete Responses and Acceptable Tolerability Profie. Case Series
Cetuximab, an anti-EGFR monoclonal antibody, has shown benefits when combined with the standard chemotherapy protocol for treating metastatic colorectal cancer (mCRC) in patients with wild-type Kras, either as the first-line or subsequent-line treatment. The most frequent profiles of toxicity are hematologic (8% grade 3 and 5% grade 4), dermatologic (24% grade 3 and 2% grade 4), acneiform exanthem (17% grade 3 and 0% grade 4) and diarrhea (10% grade 3 and 1% grade 4), which are critical for the maintenance of therapeutic regimens until disease progression. Thus, this study aims to report the cases of two patients with mCRC undergoing FOLFOX protocol associated with Cetuximab as first-line for metastatic disease. Both patients were male, older and with good clinical performance (ECOG 0,1). The subjects were followed for five years. Radiological complete responses were observed, encouraging continuity of care in Long Term Use (LTU). Clinical and radiological outcomes were unequivocally represented by complete responses, associated with acceptable and manageable tolerability profiles, culminating in overall survival (OS) over 60 months (5 years) from diagnosis. Thus, the data reported in this case series corroborate the data from current studies demonstrating benefits of anti-EGFR therapy in selected populations of patients with wild-type Kras, as first shown in OPUS study and more recently in the CALGB/SWOG 80405 study, emphasizing that treatment of mCRC with new oncogenetically guided approaches can significantly increase OS and tumor regression rates at LTU protocols.
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