Cetuximab shows activity in colorectal cancer patients with tumors that do not express the epidermal growth factor receptor by immunohistochemistry Journal Article


Authors: Chung, K. Y.; Shia, J.; Kemeny, N. E.; Shah, M.; Schwartz, G. K.; Tse, A.; Hamilton, A.; Pan, D.; Schrag, D.; Schwartz, L.; Klimstra, D. S.; Fridman, D.; Kelsen, D. P.; Saltz, L. B.
Article Title: Cetuximab shows activity in colorectal cancer patients with tumors that do not express the epidermal growth factor receptor by immunohistochemistry
Abstract: Purpose: To establish evidence of activity, or lack thereof, of cetuximab-based therapy in patients with refractory colorectal cancer with tumors that do not demonstrate epidermal growth factor receptor (EGFR) expression by immunohistochemistry (IHC). Patients and Methods: Pharmacy computer records were reviewed to identify all patients who received cetuximab at Memorial Sloan-Kettering Cancer Center in a nonstudy setting during the first 3 months of cetuximab's commercial availability. Medical records of these patients were then reviewed to identify colorectal cancer patients who had experienced failure with a prior irinotecan-based regimen and who had a pathology report indicating an EGFR-negative tumor by IHC. Pathology slides from these patients were reviewed by a reference pathologist to confirm EGFR negativity, and computed tomography scans during cetuximab-based therapy were reviewed by a reference radiologist. Response rates were reported using WHO criteria. Results: Sixteen chemotherapy-refractory, EGFR-negative colorectal cancer patients who received cetuximab in a nonstudy setting were identified. Fourteen of these patients received cetuximab plus irinotecan, and two received cetuximab monotherapy. In the 16 patients, four major objective responses were seen (response rate, 25%; 95% CI, 4% to 46%). Conclusion: Colorectal cancer patients with EGFR-negative tumors have the potential to respond to cetuximab-based therapies. EGFR analysis by current IHC techniques does not seem to have predictive value, and selection or exclusion of patients for cetuximab therapy on the basis of currently available EGFR IHC does not seem warranted. © 2005 by American Society of Clinical Oncology.
Keywords: immunohistochemistry; adult; clinical article; controlled study; human tissue; protein expression; treatment response; aged; middle aged; treatment failure; histopathology; diarrhea; drug efficacy; monotherapy; antineoplastic agents; antineoplastic agent; evidence based medicine; colorectal cancer; metabolism; computer assisted tomography; classification; epidermal growth factor receptor; antineoplastic agents, phytogenic; camptothecin; combination chemotherapy; receptor, epidermal growth factor; drug effect; pathology; cetuximab; irinotecan; monoclonal antibody; rash; colorectal neoplasms; cancer center; antibodies, monoclonal; computer; radiologist; colorectal tumor; medical record; medical records systems, computerized; drug derivative; medical assistant; oxaliplatin; pharmacy
Journal Title: Journal of Clinical Oncology
Volume: 23
Issue: 9
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2005-03-20
Start Page: 1803
End Page: 1810
Language: English
DOI: 10.1200/jco.2005.08.037
PUBMED: 15677699
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 713" - "Export Date: 24 October 2012" - "CODEN: JCOND" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Leonard B Saltz
    580 Saltz
  2. Gary Schwartz
    358 Schwartz
  3. Ki Y Chung
    43 Chung
  4. Archie Tse
    34 Tse
  5. Lawrence H Schwartz
    281 Schwartz
  6. Deborah Schrag
    137 Schrag
  7. Dorothy C Pan
    8 Pan
  8. David S Klimstra
    843 Klimstra
  9. Jinru Shia
    450 Shia
  10. Manish Shah
    174 Shah
  11. David P Kelsen
    332 Kelsen
  12. Nancy Kemeny
    347 Kemeny