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Originally published as JCO Early Release 10.1200/JCO.2004.10.182 on March 1 2004

Journal of Clinical Oncology, Vol 22, No 7 (April 1), 2004: pp. 1201-1208
© 2004 American Society of Clinical Oncology.
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Phase II Trial of Cetuximab in Patients With Refractory Colorectal Cancer That Expresses the Epidermal Growth Factor Receptor

Leonard B. Saltz, Neal J. Meropol, Patrick J. Loehrer, Sr, Michael N. Needle, Justin Kopit, Robert J. Mayer

From the Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA; Indiana University Cancer Center and the Walther Cancer Institute, Indianapolis, IN; Imclone Systems Inc, Somerville, NJ; Bristol Myers Squibb Inc, Wallingford, CT; and the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA

Address reprint requests to Leonard B. Saltz, MD, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021; e-mail: Saltzl{at}mskcc.org

PURPOSE: To evaluate the antitumor activity and toxicity of single-agent cetuximab in patients with chemotherapy-refractory colorectal cancer whose tumors express the epidermal growth factor receptor.

PATIENTS AND METHODS: Phase II, open-label clinical trial. Patients were required to have EGFr expression demonstrated on formalin-fixed paraffin-embedded tumor tissue by immunohistochemical staining before study participation. Patients were required to have received irinotecan, either alone or in a combination regimen, and to have demonstrated clinical failure on this regimen before study entry. Cetuximab was administered weekly by intravenous infusion. The first dose of 400 mg/m2 was given during the course of 2 hours. Subsequent weekly treatments were given at a dose of 250 mg/m2 during the course of 1 hour.

RESULTS: Fifty-seven eligible patients were treated. All were assessable for toxicity and response. The most commonly encountered grade 3 to 4 adverse events, regardless of relationship to study drug, were an acne-like skin rash, predominantly on the face and upper torso (86% with any grade; 18% with grade 3), and a composite of asthenia, fatigue, malaise, or lethargy (56% with any grade, 9% with grade 3). Two patients (3.5%) experienced grade 3 allergic reactions requiring discontinuation of study treatment. A third patient experienced a grade 3 allergic reaction that resolved, and the patient continued on the study. Neither diarrhea nor neutropenia were dose limiting in any of the 57 patients treated. Five patients (9%; 95% CI, 3% to 19%) achieved a partial response. Twenty-one additional patients had stable disease or minor responses. The median survival in these previously treated patients with chemotherapy-refractory colorectal cancer is 6.4 months.

CONCLUSION: Cetuximab on this once-weekly schedule has modest activity and is well-tolerated as a single agent in patients with chemotherapy-refractory colorectal cancer whose tumors express the epidermal growth factor receptor. Further studies of cetuximab will evaluate the use of cetuximab in conjunction with first-line and adjuvant treatments for this disease.

Supported by ImClone Systems Inc, Somerville, NJ.

Presented in part at the 38th Annual Meeting of the American Society of Clinical Oncology, Orlando, FL, May 18-21, 2002.

Authors' disclosures of potential conflicts of interest are found at the end of this article.


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Related Editorial

  • Targeting the Epidermal Growth Factor Receptor: An Important Incremental Step in the Battle Against Colorectal Cancer
    Lee M. Ellis and Paulo M. Hoff
    JCO 2004 22: 1177-1179 [Full Text]

Related Correspondence

  • Is Immunohistochemistry for Epidermal Growth Factor Receptor Expression a Poor Predictor of Response to Epidermal Growth Factor Receptor-Targeted Therapy?
    Mamoun Younes
    JCO 2005 23: 923 [Full Text]


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