Abstract

BackgroundThe aim of this study was to investigate the efficacy and safety of first-line panitumumab plus folinic acid, 5-fluorouracil and irinotecan (FOLFIRI) in patients with wild-type KRAS and wild-type NRAS metastatic colorectal cancer (mCRC).MethodsPatients with wild-type KRAS and wild-type NRAS mCRC presenting to the medical oncology department of the Okmeydani Training and Research Hospital in Istanbul, Turkey, between April 2014 and January 2018 were enrolled in this study.ResultsA total of 64 patients (35 males and 29 females) with a median age of 59 (35–81) years old were enrolled. The median follow-up was 18.9 months, and the median progression-free survival was 13 months. The median overall survival (OS) was 26 months in the patients with wild-type KRAS and wild-type NRAS mCRC. It was 90.4% for the 6-month OS, 79.5% for the 1-year OS, 53.7% for the 2-year OS and 31.1% for the 3-year OS. The median OS of the patients who underwent metastasectomies was 40 [95% confidence interval (CI) = 19.9–60.1] months, and the median OS of the patients without metastasectomies was 22 (95% CI = 17.7–26.4) months. There was a statistically significant difference between these (P = 0.007).ConclusionThe first-line FOLFIRI plus panitumumab was associated with favourable efficacy in the patients with wild-type KRAS and wild-type NRAS mCRC, and it was well tolerated. The removal of the metastases that became resectable after chemotherapy further prolonged the patients’ survival.Trial registrationRetrospectively registered: 33886

Highlights

  • The aim of this study was to investigate the efficacy and safety of first-line panitumumab plus folinic acid, 5-fluorouracil and irinotecan (FOLFIRI) in patients with wild-type KRAS and wild-type NRAS metastatic colorectal cancer

  • Folinic acid, infusional 5-fluorouracil and irinotecan (FOLFIRI) is a regimen recommended for use as both a first-line and second-line treatment for metastatic colorectal cancer [1]

  • The combination of panitumumab plus FOLFOX was used in the treatment of metastatic colorectal cancer (mCRC) patients, and it was found to be effective without impairing the quality of life [8, 9]

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Summary

Introduction

The aim of this study was to investigate the efficacy and safety of first-line panitumumab plus folinic acid, 5-fluorouracil and irinotecan (FOLFIRI) in patients with wild-type KRAS and wild-type NRAS metastatic colorectal cancer (mCRC). Infusional 5-fluorouracil and irinotecan (FOLFIRI) is a regimen recommended for use as both a first-line and second-line treatment for metastatic colorectal cancer (mCRC) [1]. Epidermal growth factor receptor (EGFR) inhibitors (panitumumab and cetuximab) can be used in combination with folinic acid, infusional 5-fluorouracil and oxaliplatin (FOLFOX) and FOLFIRI regimens in the treatment of wild-type KRAS (Kirsten rat sarcoma viral oncogene homologue) and wild-type. For the second-line treatment of wild-type RAS (both wild-type KRAS and wild-type NRAS) mCRC patients, the panitumumab plus FOLFIRI regimen was found to be superior to the FOLFIRI regimen alone with regard to the disease-free survival [10]. The FOLFIRI plus panitumumab regimen was found to be effective and safe for the first-line treatment of wild-type

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