A Prospective, Multicenter Phase II Study of the Efficacy and Feasibility of 15-minute Panitumumab Infusion Plus Irinotecan for Oxaliplatin- and Irinotecan-refractory, KRAS Wild-type Metastatic Colorectal Cancer (Short Infusion of Panitumumab Trial).
BACKGROUND
In some recently updated clinical guidelines, the fully humanized monoclonal antibody panitumumab, combined with irinotecan, has been recommended as an optional third-line chemotherapy for KRAS wild-type metastatic colorectal cancer (mCRC). The present prospective, multicenter phase II study evaluated the effectiveness and safety of short 15-minute panitumumab infusions.


PATIENTS AND METHODS
From January 2011 to December 2011, patients with KRAS wild-type mCRC were enrolled at 8 centers. The key eligibility criteria were age ≥ 20 years and resistance or intolerance to irinotecan, fluoropyrimidine, and oxaliplatin. All patients received 6 mg/kg of panitumumab and 150 mg/m2 or the previous tolerated dose of irinotecan, biweekly, until disease progression or unacceptable toxicity. The initial panitumumab infusion was 60 minutes, followed by a 30-minute infusion and then 15-minute infusions. The primary endpoint was the confirmed response rate using Response Evaluation Criteria In Solid Tumors, version 1.0. The secondary endpoints were progression-free survival, overall survival, and toxicity. The trial is registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN no. 000004647).


RESULTS
Of the 43 patients, the median age was 62 years (range, 32-75 years), 58% were male, and the Eastern Cooperative Oncology Group performance status was 0 to 1. The total response rate was 37.2% (95% confidence interval [CI], 23.0-53.3), and the confirmed response rate was 18.6% (95% CI, 8.4-33.4). The median progression-free and overall survival were 5.8 months (95% CI, 3.3-8.4 months) and 13.6 months (95% CI, 10.8-16.5 months), respectively. The most frequent grade 3/4 toxicities were anorexia (12%), leukopenia (9%), and neutropenia (9%). Nine patients did not reach the 15-minute infusion, primarily because of disease progression. No infusion-related reactions were observed.


CONCLUSION
The short 15-minute panitumumab infusion regimen was well tolerated, without compromising safety or efficacy in patients with KRAS wild-type, oxaliplatin- and irinotecan-refractory mCRC.
['Akiyoshi|Kohei|K|', 'Hamaguchi|Tetsuya|T|', 'Yoshimura|Kenichi|K|', 'Takahashi|Naoki|N|', 'Honma|Yoshitaka|Y|', 'Iwasa|Satoru|S|', 'Takashima|Atsuo|A|', 'Kato|Ken|K|', 'Yamada|Yasuhide|Y|', 'Onodera|Hisashi|H|', 'Takeshita|Shigeyuki|S|', 'Yasui|Hisateru|H|', 'Sakai|Gen|G|', 'Akatsuka|Sotaro|S|', 'Ogawa|Kohei|K|', 'Horita|Yosuke|Y|', 'Nagai|Yushi|Y|', 'Shimada|Yasuhiro|Y|']
D000328:Adult D000368:Aged D061067:Antibodies, Monoclonal, Humanized D000074322:Antineoplastic Agents, Immunological D000971:Antineoplastic Combined Chemotherapy Protocols D015179:Colorectal Neoplasms D019008:Drug Resistance, Neoplasm D005260:Female D006801:Humans D007262:Infusions, Intravenous D000077146:Irinotecan D053208:Kaplan-Meier Estimate D008297:Male D008875:Middle Aged D000077150:Oxaliplatin D000077544:Panitumumab D000077982:Progression-Free Survival D011446:Prospective Studies D016283:Proto-Oncogene Proteins p21(ras) D013997:Time Factors
Fully humanized monoclonal antibody mCRC Infusion-related reaction Anti-EGFR therapy Convenience of outpatient