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Anti-EGFR Therapy in Metastatic Small Bowel Adenocarcinoma: Myth or Reality?
Clinical Medicine Insights: Oncology ( IF 1.795 ) Pub Date : 2020-08-04 , DOI: 10.1177/1179554920946693
Emanuela Dell'Aquila 1 , Tea Zeppola 1 , Marco Stellato 1 , Francesco Pantano 1 , Mario Scartozzi 2 , Cristina Madaudo 1 , Filippo Pietrantonio 3 , Chiara Cremolini 4 , Giuseppe Aprile 5 , Bruno Vincenzi 1 , Roberto Moretto 4 , Marco Puzzoni 2 , Silvio Ken Garattini 6 , Riccardo Lobefaro 3 , Giuseppe Tonini 1 , Daniele Santini 1
Affiliation  

Background:

Due to the relative rarity of small bowel adenocarcinoma (SBA), prospective trials, helping to guide therapeutic decisions, are lacking and the optimal therapy for advanced SBA is unknown. The role of targeted agents, such as anti–epidermal growth factor receptor (EGFR) and anti–vascular endothelial growth factor (VEGF), is unknown.

Patients and Methods:

This is a retrospective multicenter observational study that included patients with metastatic SBA treated with anti-EGFR antibodies (cetuximab or panitumumab) ± chemotherapy in the first (I) or second (II) line.

Results:

Thirteen patients with metastatic SBA, recruited from 5 Italian referral institutions, were included in the present retrospective analysis. All patients received anti-EGFR inhibitors as a single agent or in association with chemotherapy. More common G2 treatment–related side effects were skin reaction (8 patients, 53.8%), hypomagnesemia (6 patients, 46.2%), and diarrhea (8 patients, 61.5%). Grade 3 diarrhea was observed in only 1 patient. Conjunctivitis was not reported in any patients. Grade 4 toxicity was not reported. In the overall population, median progression-free survival was 5.526 months (95% confidence interval [CI]: 3.684-12.467). Median overall survival was 15.86 months (95% CI: 14.43-24.30). Complete response was observed in 15% of patients, partial response in 39% of patients, stable disease in 23% of patients, and progression disease in 15% of patients.

Conclusions:

In this retrospective analysis, anti-EGFR inhibitors showed to be a suitable addendum to chemotherapy in the I and II line, with an excellent tolerance and safety profile both in I and II line.



中文翻译:

转移性小肠腺癌的抗EGFR治疗:神话还是现实?

背景:

由于小肠腺癌 (SBA) 相对罕见,因此缺乏有助于指导治疗决策的前瞻性试验,并且晚期 SBA 的最佳治疗方法尚不清楚。靶向药物的作用,例如抗表皮生长因子受体 (EGFR) 和抗血管内皮生长因子 (VEGF),尚不清楚。

患者和方法:

这是一项回顾性多中心观察性研究,包括在一线 (I) 或二线 (II) 中接受抗 EGFR 抗体(西妥昔单抗或帕尼单抗)±化疗治疗的转移性 SBA 患者。

结果:

从 5 个意大利转诊机构招募的 13 名转移性 SBA 患者被纳入本回顾性分析。所有患者均接受抗 EGFR 抑制剂作为单一药物或联合化疗。更常见的 G2 治疗相关副作用是皮肤反应(8 例患者,53.8%)、低镁血症(6 例患者,46.2%)和腹泻(8 例患者,61.5%)。仅在 1 名患者中观察到 3 级腹泻。没有任何患者报告结膜炎。未报告 4 级毒性。在总体人群中,中位无进展生存期为 5.526 个月(95% 置信区间 [CI]:3.684-12.467)。中位总生存期为 15.86 个月(95% CI:14.43-24.30)。在 15% 的患者中观察到完全缓解,在 39% 的患者中观察到部分缓解,在 23% 的患者中疾病稳定,

结论:

在这项回顾性分析中,抗 EGFR 抑制剂被证明是 I 和 II 线化疗的合适补充,在 I 线和 II 线均具有出色的耐受性和安全性。

更新日期:2020-08-04
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