Podcasts about Cetuximab

BUFFALO, NY - February 18, 2025 – A new #researchpaper was #published in Oncotarget, Volume 16, on February 12, 2025, titled “Could Panitumumab with very low dose Capecitabine be an option as a maintenance regimen." In this study, researchers Doaa A. Gamal, Aiat Morsy, and Mervat Omar from Assiut University Hospital, evaluated a new maintenance treatment for metastatic colorectal cancer (mCRC). Their findings suggest that a combination of two drugs—Panitumumab, a targeted therapy that blocks a protein called epidermal growth factor receptor to slow cancer growth, and low-dose Capecitabine, a chemotherapy drug that converts into 5-fluorouracil (5-FU) inside the body to stop cancer cells from growing and dividing—could help extend survival in patients with mCRC. This regimen appears to be both effective and well-tolerated, especially for patients with wild-type KRAS mCRC who had previously responded to treatment. Colorectal cancer is one of the leading causes of cancer-related deaths worldwide. Standard treatment often involves a combination of chemotherapy and targeted therapies, but many patients face challenges related to treatment toxicity and resistance, which can lead to treatment interruptions. This study tested whether a lower-intensity maintenance treatment could help keep the cancer under control after initial treatment. The study involved 25 mCRC patients with wild-type KRAS and BRAF, who first received six rounds of standard 5-FU-based chemotherapy with Panitumumab. Patients who responded well then switched to a maintenance treatment of Panitumumab every two weeks and a low, continuous dose of Capecitabine. The results showed that patients had a median progression-free survival of 18 months and a median overall survival of 45 months, indicating a strong potential benefit. Patients with metastases detected at the same time as the primary tumor showed a longer progression-free survival than those with metastases appearing later. The treatment was also well tolerated, with only 8% of patients experiencing severe side effects such as skin rash or diarrhea, which were managed with standard treatments. "In our research, the toxicity profile was very acceptable, and no patients needed to stop treatment or had a dose modification due to toxicity." Finding a way to keep cancer under control while reducing side effects is a major goal in cancer treatment. While other maintenance therapies like Bevacizumab and Cetuximab have been studied, this research suggests that Panitumumab with low-dose Capecitabine could be a promising new option. Panitumumab is already an FDA-approved drug, but its role in maintenance therapy had not been extensively explored. The results of this study suggest that this combination may help delay disease progression while keeping side effects manageable, ultimately improving patients' quality of life. Although larger studies are needed, these findings open the door for further clinical trials to confirm the benefits of this regimen. If validated, this approach could change the standard of care for mCRC patients, particularly those who cannot tolerate more intensive chemotherapy. DOI - https://doi.org/10.18632/oncotarget.28687 Correspondence to - Doaa A. Gamal - doaaalygamaal@gmail.com Video short - https://www.youtube.com/watch?v=wuPSS0EdK-8 To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

Welcome to another episode of the Oncology Brothers podcast! In this episode, Drs. Rahul and Rohit Gosain are joined by Dr. Alok Khorana, a GI medical oncologist from the Cleveland Clinic, to discuss the latest highlights from the GI ASCO 2025 conference. We dive into four key studies that are practice-informing and potentially practice-changing: 1. BREAKWATER: We explore the implications of using Encorafenib and Cetuximab in combination with FOLFOX for patients with BRAF V600E mutations, which are associated with poor prognosis. 2. CheckMate-8HW: This study investigates whether dual checkpoint inhibition is more effective than single-agent immunotherapy for MSI-high patients, revealing promising results in progression-free survival. 3. Aspirin in Adjuvant Settings: We discuss the role of low-dose aspirin in reducing recurrence rates for patients with PI3K alterations, highlighting its potential as a practice-changing intervention. 4. STARTER-NET: Finally, we review the findings from the study on Everolimus combined with Lanreotide for neuroendocrine tumors, noting the lack of overall survival benefit. Tune in for an insightful discussion on these important topics in oncology, and learn how these findings could impact treatment strategies in your practice. Don't forget to like, subscribe, and check out our other episodes for more conference highlights and treatment discussions! YouTube: https://youtu.be/YOToz3hKYTg Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers #OncologyBrothers #GIASCO2025 #ColorectalCancer #Immunotherapy #NeuroendocrineTumors #CancerResearch #Podcast

Welcome to another episode of the Oncology Brothers podcast! In this episode, Drs. Rahul and Rohit Gosain are joined by Dr. Pashtoon Kasi from City of Hope to discuss the management of side effects associated with key treatments utilized in colorectal cancer, but also in other tumor types.  We dived deep into two important drug classes: Bevacizumab, an anti-VEGF antibody, and the anti-EGFR antibodies, Panitumumab and Cetuximab. Dr. Kasi provided a comprehensive overview of these targeted therapies, their mechanisms of action, and the common side effects that patients may experience. Key topics covered in this episode included: •⁠  ⁠Overview of Bevacizumab and its side effects, including hypertension, proteinuria, and risk of bleeding. •⁠  ⁠Clinical pearls for managing side effects associated with Bevacizumab. •⁠  ⁠Discussion on the skin toxicities, nail changes, and electrolyte imbalances related to Panitumumab and Cetuximab. •⁠  ⁠The importance of preemptive strategies in managing skin rashes and other side effects. •⁠  ⁠Insights into infusion reactions with Cetuximab and considerations for patient safety. Join us for this informative discussion that aims to enhance your understanding of these critical therapies and improve patient outcomes.  Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers Don't forget to check out our other episodes in the Tox Check series, where we explore antibody-drug conjugates and CAR T therapies. Subscribe to our channel for more insights on oncology treatments and patient care!

Check out this week's QuadCast as we highlight the oncologic benefit of extended nodal dissection for prostate cancer, the comparison of Durvalumab and Cetuximab in cisplatin-ineligible H&N cancer patients, the high incidence of psoriasis development on immunotherapy, and more. Check out the website and subscribe to the newsletter! www.quadshotnews.com Founders & Lead Authors: Laura Dover & Caleb Dulaney Podcast Host: Sam Marcrom

Colorectal cancer remains the bread and butter of many an oncologist, but its commonality belies its complexity. In early and advanced disease alike, there remain many permutations, considerations and controversies regarding optimal treatment. What is the best way to treat potentially-resectable colorectal cancer with liver metastases (CRLM)? Is there a way to increase the responsiveness to immunotherapy in patients with proficient mismatch repair (pMMR)? And are we moving to a brighter future where patients with deficient MMR colorectal cancer could avoid surgical management through the miracle of immunotherapy? Ultimately, no one study is going to answer these questions, but with ESMO 2023, we may be starting to peel back the layers of this onion.Studies discussed in today's episode (subscription may be required)Cetuximab plus FOLFOXIRI versus cetuximab plus FOLFOX in RAS wild-type patients with initially unresectable colorectal liver metastases: The TRICE randomized clinical trial https://esmocongress.esmo.org/esmo/esmo2023/en-GB/presentation/638067Neoadjuvant nivolumab plus relatlimab (anti-LAG3) in locally advanced MMR-deficient colon cancers: The NICHE-3 study https://esmocongress.esmo.org/esmo/esmo2023/en-GB/presentation/639575A phase II clinical trial of sintilimab plus chidamide combined with or without bevacizumab in patients with MSS/pMMR metastatic colorectal cancer https://esmocongress.esmo.org/esmo/esmo2023/en-GB/presentation/638079For more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of Music Unlimited: https://pixabay.com/users/music_unlimited-27600023/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice. Hosted on Acast. See acast.com/privacy for more information.

A new research paper was published in Oncotarget's Volume 14 on July 7, 2023, entitled, “Effectiveness and toxicity of cetuximab with concurrent RT in locally advanced cutaneous squamous cell skin cancer: a case series.” Treatment for locally advanced cutaneous squamous cell cancers (laCSCC) remains poorly defined. Most laCSCC tumors express high levels of epidermal growth factor receptors (EGFR). Cetuximab has activity in other EGFR expressing cancers and enhances the effectiveness of radiotherapy. In this new study, researchers Mark Chang, Wolfram Samlowski and Raul Meoz from University Medical Center of Southern Nevada, Comprehensive Cancer Centers of Nevada, University of Nevada Las Vegas, and University of Nevada Reno conducted a retrospective review of institutional data and identified 18 patients with laCSCC treated with cetuximab induction and concurrent radiotherapy. “We performed a retrospectively review of treatment outcome and toxicity in our patients who received concurrent cetuximab and radiotherapy to show an additional potentially effective treatment option for patients with laCSCC. The goal is also to provide data to inform the design of potential prospective clinical trials.” The loading dose of cetuximab was 400 mg/m² IV. Subsequent weekly doses of 250 mg/m² IV were infused throughout the period of radiation. The treatment doses ranged from 4500–7000 cGy, with a dose fraction of 200-250 cGy. The objective response rate was 83.2% with 55.5% complete responses and 27.7% partial responses. Median progression-free survival was 21.6 months. Progression-free survival was 61% at 1 year and 40% at 2 years. With longer follow-up, some patients developed a local recurrence (16.7%), distant metastases (11.1%) or a second primary cancer (16.3%). Cetuximab was well tolerated, with 68.4% patients experienced only mild acneiform skin rash or fatigue (Grade 1 or 2). Radiotherapy produced expected side effects (skin erythema, moist desquamation, mucositis). “Cetuximab plus radiotherapy represents an active and tolerable treatment option for laCSCC, including patients with contraindications for checkpoint inhibitor therapy.” DOI - https://doi.org/10.18632/oncotarget.28470 Correspondence to - Wolfram Samlowski - wsamlowski1@gmail.com Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28470 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - keratinocyte carcinoma, squamous cell skin cancer, cetuximab, epidermal growth factor receptor, radiation therapy About Oncotarget: Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. To learn more about Oncotarget, visit Oncotarget.com and connect with us on social media: SoundCloud - https://soundcloud.com/oncotarget Facebook - https://www.facebook.com/Oncotarget/ Twitter - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ For media inquiries, please contact: media@impactjournals.com.

In part one of a two-part conversation, Drs. Patrick Loehrer and David Johnson sit down with Dr. Deborah Schrag to discuss her roles as a leader, researcher, oncologist and public health expert. The current Chair of the Department of Medicine at Memorial Sloan Kettering Cancer Center in New York, Dr. Schrag discusses the joy and passion she has found throughout her career, and more. If you liked this episode, please subscribe. Learn more at https://education.asco.org, or email us at education@asco.org.   TRANSCRIPT Dr. Pat Loehrer: I'm Pat Loehrer. I'm the Director of the Center of Global Oncology and Health Equity at Indiana University. Dr. David Johnson: Yes. And hello, I'm David Johnson. I'm at UT Southwestern in Dallas, Texas. Dr. Pat Loehrer: And welcome to another version of Oncology, Etc. Dr. David Johnson: Yeah, great guest today, before we get started with our guests, though, Pat, what are you reading these days? What can you recommend to me? Dr. Pat Loehrer: Well, I'm reading Jamie Raskin's book, which is about his son and about the insurrection. It's really a wonderful read so far, particularly I think about the family nature and how much he deeply respected his son who unfortunately committed suicide. Dr. David Johnson: Right before one of the impeachment trials as I recall, right? Dr. Pat Loehrer: It was right before the January 6 insurrection. Dr. David Johnson: Yeah, terrible situation. I have a book I've been meaning to recommend for a while. It's one that I've given to all the chief residents I've worked with over the last several years. And today's guests made me think about this book. It's entitled, Osler: Inspirations from a Great Physician. It's written by Charles Bryan, who's the former Chair of Medicine at the University of South Carolina in Columbia. Dr. Pat Loehrer: You trained with Osler, didn't you? Dr. David Johnson: I was a couple of years behind him. He was my senior resident. For anyone who's an Oslerphile, it's a great book to have. But even if you're not, it's got some wonderful lessons to be learned about how to interact with one's colleagues, and a lot of information about leadership, which is why it made me think of today's guest, Dr. Deborah Schrag who we're really excited to welcome to Oncology, Etc. Dr. Schrag is the Chairman of the Department of Medicine at Memorial Sloan Kettering Cancer Center in New York. She's a highly accomplished healthcare leader, clinician-researcher, and expert in public health and population science. Deborah received her medical degree from Columbia University and completed her residency in internal medicine at Brigham and Women's. She obtained her medical oncology training at Dana-Farber in Boston and also received an MPH degree from the Harvard School of Public Health. After a brief stint on the faculty at DFCI and Brigham and Women's, she joined the division of gastrointestinal Oncology at Memorial Sloan Kettering, where she was an associate member and Associate Professor of Public Health and Medicine. In 2007, I believe it was, she returned to Dana-Farber and Brigham, where she continued her work focused on improving the delivery, quality, and effectiveness of cancer care. While there, she served as chief of the Division of Population Sciences until this past year when she returned to Memorial to chair the Department of Medicine. I also think she's the first woman to hold this position, but we'll learn about that momentarily. Deb is internationally recognized as a pioneer for her work engaging patients in reporting outcomes as a way to improve care. She has led pragmatic trials using informatics strategies to optimize patient and clinician wellbeing, efficiency and quality, and equity of care. In short, she's a true superstar, leading the department, the major department, in one of the world's foremost Cancer Institutes. Deb, welcome to Oncology, Etc. Thank you so much for accepting our invitation. This is a relatively new oncology podcast, but already, we're known for our incisive, deeply penetrating questions. So, I have a question for you to start off. Do you have any carpentry skills? Dr. Deborah Schrag: Absolutely none whatsoever, Dave. None. Dr. David Johnson: I'm disappointed. It's my understanding that Schrag is German for cross or a slant and people who build cross-legged tables. So, I was hoping, my house was destroyed recently, and I'm looking for replacement furniture, and I was hoping you might be able to help me. Dr. Deborah Schrag: I apologize. But I'm not going to be able to help. The name, you're correct, though, David, is a German name. So, my family does hail from Germany and they made malt, which is the major ingredient in beer. I'm not sure where the name comes from. But they ran malt factories and shipped malt all over to all the beer, before there were craft beer distilleries, that's what they did. Dr. Pat Loehrer: That may come in handy by the end of this podcast, by the way. Dr. Deborah Schrag: Could be. Dr. David Johnson: Well, speaking of your family, tell us a little bit about your background and where you were raised, and your family members. Dr. Deborah Schrag: Sure! I'm glad you asked that because I really have been very influenced by where I grew up. And as I think about it, experiences that go back to first grade got me where I am today. So, I am from New York City. I grew up in Manhattan in the 1970s. And as you may know, that was a pretty rough time in the history of New York, what's often referred to as the 'bad old days', although it didn't feel that way to me. But I started out attending New York City public schools. And at that time in my neighborhood on the Upper West Side of Manhattan, my first-grade class had about 45 students, and one teacher, there were about five or six of us who spoke English, and everyone else was a recent Puerto Rican immigrant. I pretty much sat in the corner and read to myself. Now I didn't stay in the public school system for long, but I saw in first grade, how things weren't fair. And I saw and felt my own privilege, acutely. And even as a little kid, I had that sense. Eventually, my parents transferred me to private school later on. And there were kids in the neighborhood who didn't have the same privileges that I did. But living in New York, you walk around, you're confronted with disparities every day. We still see it today with homelessness on the streets. At that time, there was a lot of alcoholism and the use of drugs. And they were two blocks north that were safe to walk and two blocks east that were not safe to walk. So, this really stuck with me from a very early age. As a student in summer jobs, I worked lots of interesting jobs. I started at 14 scooping ice cream at Baskin Robbins, I worked at a famous Deli in New York called Zabar's, selling coffee. Lots of interesting jobs that I worked during holidays and vacation times. But one of my first jobs was working in an organization called the Floating Hospital, which was a big old ferry boat that circumnavigated Manhattan, and it provided a summer camp. And we would take 1800 people on a boat around Manhattan every day. And my job was to do lead testing. And I learned how to stick kids, test them for lead because there were incredible amounts of lead poisoning in New York City in the early 1980s. And then we would work on tracing the kids and these were toddlers, two-year-old, three years old. There were many families who were living in homeless shelters in New York City in the early 1980s. And that was really the beginning of my interest in public health and inequities. And really the marriage of medicine and public health. That had a deep and long-lasting impression on me and really stayed with me throughout my career. That early experience, I think it propelled me into medicine and to medical school and also to marry medicine and public health. Dr. Pat Loehrer: Tell me a little bit, Deb, about your parents. Dr. Deborah Schrag: Sure! My mother was born in the United States. She was a teacher who many years later after having three children went to law school and she became a litigator. And actually, her boss was Rudolph Giuliani. My father is a child of World War II. He was a child of German Jewish parents who had to flee the Nazis. Probably the most interesting story is that my paternal grandfather was an OB-GYN. So, I am a fifth-generation physician. My paternal grandfather was an OB-GYN at Charité, which is a very famous Hospital in Berlin. He was the head of OB-GYN there in the 1930s. But he had, I think he was half Jewish, and the Gestapo asked him to leave and he had to leave. He was an expert in version, which is essentially flipping babies and the setting of placenta previa. He then left for Lebanon, where he was in the French Resistance and had a thriving OB-GYN practice in Beirut, Lebanon, during World War II. And at night, there was a curfew, and he was part of the resistance and passed secrets around from the Russians to the French, so very dramatic. My father was born in this setting, and arrived as a new immigrant to the United States in the 1940s, where it was very hard to be a child whose parents had a German accent, given the prejudice against Germans at that time, but also went to New York City public schools, had a tremendous opportunity. It's really kind of the classic New York immigrant success story. You know, arrived in the United States with the shirts on their back and managed to work their way to a better life and achieve success and good education through public education for all their offspring. I will also say that my father had a public health stint. He worked in North Carolina as an alternative to going and serving in the Vietnam War, he was in the Public Health Service. And he worked in North Carolina in the textile mills and worked on a disease called byssinosis, which is also known as the brown lung. It's an occupational health disease that affects textile mill workers. As a child, I spent many dinners, hearing about byssinosis and brown lung, and black lung. I think at an early age I really came to understand how the world wasn't fair, and how it was instilled in me early on that it was important to work to try to make things better, particularly for people who didn't have privilege. And I think when you come from an immigrant family, and you realize how much privilege has been bestowed on you, that really leaves an indelible mark. I have to say, as Chair of Medicine at MSK, it is staggering to me the proportion of faculty here at MSK, but also at Dana-Farber, where I worked previously, we have lots and lots of immigrants who've been able to accomplish just amazing things through just motivation and drive and energy and creativity. And so, I'm a big believer in how much immigrants have powered this country. Dr. Pat Loehrer: Deborah, are your parents still alive? Dr. Deborah Schrag: My parents are still alive. They're both in their early 80s. And they both still live on the Upper West Side of Manhattan. So, I'm very privileged and fortunate to have living parents. Dr. Pat Loehrer: I can imagine the pride that they have for you. Dr. David Johnson: I just want to jump in and let our listeners know that Deb mentioned Charité in Berlin. That's the home of multiple Nobel laureates that all of us would know like Ernst Chain, who was one of the individuals involved in the development of penicillin, but Paul Ehrlich, Robert Koch, Hans Krebs, and for cancer doctors, Otto Warburg, among others. So, it truly is a world-renowned institution. Dr. Deborah Schrag: Well, my paternal grandfather was famous for this technique called version, which essentially involves putting your stethoscope next to the uterus, figuring out where the placenta was, and then essentially trying to flip the baby without disrupting the placenta or causing any harm, which required incredible skills with a stethoscope because you had to appreciate, I guess, the placental vessels. I'm not aware that this skill is still in existence, it was an important skill to have in the 1930s. When, if you did a C-section, there was a high probability of endometritis. So, you could save the baby, but you would often lose mom to endometritis. Or you could save mom, but you might not save the baby. So, at that time it was a big deal, but thankfully no longer. Dr. David Johnson: This is why we call it an Oncology, Etc. Our listeners didn't know that we're gonna get OB information in this particular podcast. Dr. Deborah Schrag: Or a digression on the history of medicine. I do find that, you know, I am inspired by the generations that came before me. I think it's also true that there are many physicians who are first-generation physicians in their families and some of us are privileged to have lots of healthcare professionals and sort of feel it as a calling. Dr. David Johnson: I think of you with many, many talents. But one of the things that I think stood out to me is, many years ago, you were in the van, talking about the financial cost of health care. I remember a very influential paper you wrote in the New England Journal, talking about the cost of treating GI cancer, colon cancer in particular. But where did your interest in that particular aspect of health care begin? What was the stimulus there? I mean, obviously you had a lot of stimulus from your family. What else? Dr. Deborah Schrag: That's really interesting. This is a little bit of a history of oncology. At that time, I was an assistant professor and assistant attending in the GI oncology service, seeing lots of patients with colorectal cancer. And we were working on a clinical trial of a drug called ImClone C225. And that was the name of the protocol. And we were putting patients in that clinical trial. And you know what? This drug was working. We were getting excited and the drug was moving ahead. We looked at the Phase 1 data and we launched Phase 2. We had meetings with the research protocol nurse and the research assistants, team meetings, and I would say there were about 50 people who were aware between the GI oncologists and the nurses and all the research assistants. You guys know that it takes a village and even though the villages were smaller then and it wasn't a particularly large trial, there are many, many people involved and everyone had the sense that this drug might be working. Just for context for our younger listeners, this is back in the early aughts, and basically, the drug that we had to treat colorectal cancer was 5-FU in many different formats and Irinotecan. And that was it. Some people thought mitomycin might work a little bit, but it was so horrible that it really barely worked. But that was what we had in our bag of tricks. So, the fact that we had this ImClone drug that eventually came to be known as Cetuximab, was remarkable. So, here's what happened. It turned out that this is the drug made by the company ImClone. And there were some shenanigans, some insider trading. And one of the people caught up in insider trading, in addition to some people involved with the company itself was none other than Martha Stewart, sort of the famous homemaker who still publishes magazines to this day. And you may know that she actually did some time in federal prison as a result of insider trading on this drug. I remember being a junior attending, and all the people involved in the trial and all the cancer professionals, we all knew this was working. But everyone respected the confidentiality of the situation, of the patients, and all the integrity that goes into academic medicine. And I remain inspired by the integrity of all the professionals, the doctors, the residents. These were not affluent people. I can tell you. we were not paying research assistants a whole hunk of money. They investigated every trade made by this company. There were absolutely no shenanigans or improprieties from the hard-working folks who helped bring this drug to market. So, as this was going on, we had many patients who were not eligible for the trial who were interested in getting the trial. So, of course, we followed as this drug got FDA approved and came to market. You could check me but I believe it was February 2004, it was FDA approved. It came out with a huge price tag. It was approximately $10,000 per month. I was mad because I was taking care of regular New Yorkers at that point. I had public school teachers, I had patients on Medicare and they couldn't afford the 20% copay. Because $10,000 a month for Cetuximab, if you have a 20% copay and you're New York City, public school cafeteria worker, is not yet eligible for Medicare with a typical plan that a New York City public school system employee would have, that was $2,000 a month. And that did not work for one of my patients who is essentially what we used to call a lunch lady. I was so mad that I decided to channel that anger into writing what I think is a perspective for the New England Journal called, “The Price Tag on Progress”. I wrote that piece. I know that many, many people and many of my esteemed colleagues have continued to work in that area and do research on the economics of drug pricing and there are many, many experts. I didn't stick with that. Not that it's not interesting, and not that it's not important. It's incredibly interesting and important, but I felt that the solution needed to happen in the legislature, state legislature, federal legislature. I think that this is about social policies, and we need to advocate for appropriate health insurance programs to make it possible for people to get coverage when they have catastrophic illnesses, and we need to think about the entire approach to drug pricing in this country. I still think that's important. I'm not convinced that what we need is more research on the topic. I think we need more policymaking and laws on the topic. I think we're still dealing with this. I'm sad to say that it's been nearly 20 years since I wrote that perspective. But I think it was motivated by frustration, not being able to get my patient what she needed, and many patients thereafter. And just the incongruity between some people benefiting from insider trading and all the good people who were doing the right thing. Dr. Pat Loehrer: I just want to throw in one thing if I can. Len Saltz, who's one of your partners, it was a piece of that trial that he presented at ASCO talking about ImClone C225. And ironically, it had a 22.5% response rate. And Len said, it's a bummer that ImClone didn't call it C995. Dr. Deborah Schrag: You have no idea how often we used to talk about that, joke about that in the clinic. I have another good story about that drug, which I think really illustrates something I believe and I think it's actually something that Osler said but it's also something I have to say I learned from both of you. And it has to do with listening to your patient. So, I had a patient named Matthew, who was a young man, 34 years old. He walked into my clinic with a diagnosis of diffuse metastatic colorectal cancer with multiple bilateral pulmonary metastases, which came to light when his tennis game was off. He was, at that time, an early employee of a newly started company called Google. And he was working on advertising algorithms, and Matt got the drug Cetuximab. And unfortunately, he was on it for quite some time. He was on it for about five or six months. But eventually, it was pretty clear that we were coming to the end of the road. And he and his wife planned a vacation. This was part of his end-of-life process planning. It was their fifth wedding anniversary in the Berkshires. We worked so hard to get Matt to the Berkshires to a beautiful inn, and on Saturday night, my pager goes off, and Matt cannot sit up. He's weak. And he'd been complaining of terrible fatigue for weeks, to me, and I really hadn't quite figured out why Matt was so fatigued. I mean, I just didn't understand it. And we get into this inn and I get a call from the Berkshire Medical Center, a small community hospital, 'Dr. Schrag, your patient is here. He's so weak and he can't sit up.' 'What's going on?' The ER doctor says, 'Well, he has a Chvostek sign', which is a sign of severe hypocalcemia. 'So, call me back with the calcium.' The calcium is low. Well, I think those of your listeners who are closer to medical school know that when the calcium is low, you have to check the mag. And Matt's magnesium was 0.2. And he got some magnesium in the Berkshire Medical Center. And all of a sudden, he felt great. He was able to go on and enjoy the second half of his fifth anniversary weekend at the Berkshire Inn and he came back. And I felt terrible because he'd been complaining to me of fatigue for six weeks and I hadn't checked his magnesium. I was like, 50 bilateral pulmonary metastases on chemotherapy. That's a fatigue explanation. Suffice it to say that we went on to start checking magnesium on everyone getting Cetuximab. Now mind you, the drug is FDA approved and FDA labeled at this point. So, we started checking magnesium, and we find that it was low. I start getting on the phone and calling my mentors. I called Dr. Bob Mayer, who was the head of my fellowship director and was like a revered mentor to me. 'Hey, Bob, does anyone up there in Boston have low magnesium from Cetuximab?' 'We don't check magnesium.' I said, 'But can you check?' I started calling around and that's a great example of the community of oncology. We are a community. I just started working the phones and calling friends and saying 'You guys checking magnesium for any of these folks on Cetuximab?' Suffice it to say, we figured out that their EGFR receptors in the ascending loop of Henle - so, again, back to biology and pathophysiology - the drug Cetuximab was blocking reabsorption of magnesium in the kidney, and it was Cetuximab that caused a terrible magnesium wasting. Oral magnesium did not work. You had to give it intravenously, repeatedly. And we helped eliminate fatigue for a bunch of patients. About six months later, I showed up at ASCO with these little cardboard slides and a little poster back in the corner and put up our little case series, very little. But I'm proud to say that we changed the label of Cetuximab and it's now on the label that it causes hypomagnesemia. It might be one of my more cited papers, paradoxically. But I think it's a principle that really has stuck with me, and I've tried to impart it to all the students and residents and fellows, 'Listen to your patients because - I think it comes from Osler- they're telling you something. We have to pay attention.' Again, I have never forgotten that. But really listening and trying to figure out how we can use our understanding of pathophysiology and what our patients tell us to ask questions and not just accept dogma and try to figure out what we can do. And you know, I couldn't have figured that out on my own. I happened to find a really smart nephrologist who happened to be able to sort of go to animal models and knew the right studies and the right people to talk to. Dr. David Johnson: It's one of the reasons why we are a multidisciplinary specialty. And we use the expertise of our colleagues. I think that's such a wonderful example of listening to one's patient and it really profoundly impacted our understanding of how that drug works and renal physiology, actually. That wraps up part one of our interview with Dr. Deborah Schrag, Chair of Medicine at Memorial Sloan Kettering Cancer Center. We hope you've enjoyed learning about her background and her early career. In part two of our conversation, Dr. Schrag will discuss her programmatic goals at Memorial Sloan Kettering, the importance of mentorship and leadership, and what it means to have joy in the profession of medicine, and, frankly, much more. So, please be sure to join us. As always, we want to thank you for tuning in to Oncology, Etc. an ASCO educational podcast, where we will talk about just about anything and everything. So, if you have an idea for our topic or a guest, please email us at education@asco.org. Unknown Speaker: Thank you for listening to the ASCO Education Podcast. To stay up to date with the latest episodes, please click subscribe. Let us know what you think by leaving a review. For more information, visit the comprehensive education center at education.asco.org.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement.

We wrote, CMS listened! Cetuximab MUE increased to 150 units to accommodate new dosing regimen.

A new dosing regimen approved by the FDA on April 6, 2021 exceeds the current MUE if administered to a patient with a BSA of 3 m2. Pharmacy Revenue Cycle requested an increase which the NCCIPTP Coordinator has indicated will be implemented in a future quarterly update.

Listen to a soundcast of April 6th & 7th FDA approvals of Erbitux (cetuximab) for K-Ras wild type, EGFR-expressing colorectal cancer or squamous cell carcinoma of the head and neck and Trodelvy (sacituzumab govitecan) for unresectable locally advanced or metastatic triple negative breast cancer.

An internal stoush at Pharmac means funding for a drug for terminal bowel cancer patients have been shelved for more than a decade. The Cancer Society's medical director Chris Jackson told reporter Ruth Hill the drug Cetuximab can give patients months or even years more life.

An internal stoush at the drug-buying agency Pharmac has blocked funding for a life-extending drug for bowel cancer patients, that's available in 52 other countries. Meanwhile, patients are going into debt to pay tens of thousands of dollars for the drug Cetuximab, which can extend their lives by months or even years. Ruth Hill reports.

A combinação de anticorpos monoclonais com quimioterapia oferece benefícios para pacientes com tumores avançados ou metastáticos. HOWEVER qual deles tem maior eficiência em pacientes não tratados previamente? Estamos falando do cetuximab e bevacizumab novamente! Estamos quase lá! O objetivo é fazer um “background” sobre o assunto e discutirmos em breve a questão da lateralidade para câncer colorretal (ccr). O SWOG Trial, publicado no JAMA em 2017, teve o objetivo comparar a combinação de cetuximab vs. bevacizuma com FOLFIRI ou FOLFOX no tratamento de pacientes com ccr “KRAS wyld-type”. Siga-nos nas redes sociais e faça seus comentários! Sejam muito bem vindo a mais um episódio do Clinical Papers Podcast! Para saber mais sobre esse paper, acesse o link abaixo e tenha acesso grátis na íntegra! https://www.ncbi.nlm.nih.gov/pubmed/28632865

Spine SBRT constraints, HYPRO, CDDP > Cetuximab, and Psoriasis quadshotnews@gmail.com @QuadShotNews

Prof Taïeb speaks with ecancer at ESMO 2016 about the improved patient outcomes following the addition of cetuximab, an EGFR inhibitor, to standard FOLFOX therapy for patients with full RAS and BRAF wild type. This follows similar results for adding cetuximab to FOLFOX in RAS wildtype metastatic colorectal cancer, reported at the ESMO 18th World Congress on Gastrointestinal Cancer. Prof Taïeb outlines the results of this trial, and considers what this might mean for patients depending on their tumour genotype, tumour location, and the suitability of similar combinations with panitumumab and bevacizumab.

By Amanda Psyrri  The findings of KEYNOTE-055 are summarized and compared to other immunotherapy studies in recurrent/metastatic head and neck squamous cell carcinoma. Related Article:  Pembrolizumab for Platinum- and Cetuximab-Refractory Head and Neck Cancer: Results From a Single-Arm, Phase II Study

Dr. Nathan Pennell, Cleveland Clinic, describes other options for treatment of acquired resistance, including chemotherapy, ablation with SBRT and a combination of Gilotrif and Erbitux.

Dr. Nathan Pennell, Cleveland Clinic, describes other options for treatment of acquired resistance, including chemotherapy, ablation with SBRT and a combination of Gilotrif and Erbitux.

Dr. Nathan Pennell, Cleveland Clinic, describes other options for treatment of acquired resistance, including chemotherapy, ablation with SBRT and a combination of Gilotrif and Erbitux.

Dr. Jeffrey Bradley, Radiation Oncologist at Washington University in St. Louis, provides trial evidence showing that patients may not benefit from high dose chest radiation therapy vs. standard dose therapy.

Dr. Jeffrey Bradley, Radiation Oncologist at Washington University in St. Louis, provides trial evidence showing that patients may not benefit from high dose chest radiation therapy vs. standard dose therapy.

Dr. Jeffrey Bradley, Radiation Oncologist at Washington University in St. Louis, provides trial evidence showing that patients may not benefit from high dose chest radiation therapy vs. standard dose therapy.

Drs. Jack West and Greg Riely field questions about which treatments should EGFR lung cancer patients consider when their cancers progress.

Drs. Jack West and Greg Riely field questions about which treatments should EGFR lung cancer patients consider when their cancers progress.

Drs. Jack West and Greg Riely field questions about which treatments should EGFR lung cancer patients consider when their cancers progress.

Dr. Jack West suggests that progression in T790M-negative EGFR lung cancer patients may not require a change in therapy. In this video he details what should go into the decision to modify treatment for those patients.

Dr. Jack West suggests that progression in T790M-negative EGFR lung cancer patients may not require a change in therapy. In this video he details what should go into the decision to modify treatment for those patients.

Dr. Jack West suggests that progression in T790M-negative EGFR lung cancer patients may not require a change in therapy. In this video he details what should go into the decision to modify treatment for those patients.

Der in der Therapie von metastasiertem KRK und SCCHN etablierte Antikörper Cetuximab hat als häufige Nebenwirkungen Hypocalcämie, Hypomagnesiämie und ein akneiformes Exanthem. In der vorliegenden Arbeit wurde untersucht, ob die Verläufe der Serumspiegel von Magnesium und Calcium sowie das Auftreten eines akneiformen Exanthems mit Baseline Patientenmerkmalen assoziiert ist. Zusätzlich wurden diese drei Nebenwirkungen mit dem Therapieansprechen und den Überlebenszeiten (PFS und OS) korreliert. Der Abfall des Serummagnesiumspiegels war dabei über die Therapiedauer progredient. Erstmals konnte ein stärkerer Abfall des Serummagnesiums nachgewiesen werden wenn neben Cetuximab eine Chemotherapie mit einem Platinderivat benutzt wurde. Keine der Baselinecharakteristika der Patienten war mit dem Auftreten einer Hypomagnesiämie assoziiert. In der Untergruppe der Patienten mit metastasierten kolorektalen Karzinom war ein Abfall des Magnesiumwertes um mehr als 5% des Ausgangswert nach zwei Therapiewochen signifikant mit einem längeren progressionsfreien Überleben und Gesamtüberleben assoziiert. Für das Auftreten einer Hypocalcämie fand sich eine eingeschränkte Nierenfunktion vor Therapiebeginn als unabhängiger Risikofaktor. Im Mittel fiel der Calciumwert nur um 3-5% vom Ausgangswert ab und verblieb dann auf diesem Niveau. Ein Abfall des Calciumwertes nach sechs Wochen Therapie auf weniger als 93,9% des Ausgangswertes war mit einem signifikant kürzerem Gesamtüberleben assoziiert. Das Auftreten eines akneiformen Exanthems korrelierte zwar mit dem der Hypomagnesiämie, es konnten jedoch nur leichte, nicht statistisch signifikante Vorteile im Gesamtüberleben und dem progressionsfreien Überleben für die hier untersuchte heterogene Patientengruppe festgestellt werden. In der täglichen Praxis sollte unter einer Therapie mit Cetuximab regelmäßige Kontrollen des Magnesiumspiegels durchgeführt werden. Nur so kann erkannt werden, dass unspezifische Beschwerden der Patienten wie Müdigkeit nicht nur tumorbedingt sondern eventuell auch durch Cetuximabtherapie bedingt sind.

Immunotherapy Forum Video #29: In part 2 of 2, Dr. Jason Luke discusses treating cancer with immunotherapy and another drug, such chemotherapy or targeted therapies, as well as what we know about biomarkers that predict if an immunotherapeutic will work.

Immunotherapy Forum Video #29: In part 2 of 2, Dr. Jason Luke discusses treating cancer with immunotherapy and another drug, such chemotherapy or targeted therapies, as well as what we know about biomarkers that predict if an immunotherapeutic will work.

Immunotherapy Forum Video #29: In part 2 of 2, Dr. Jason Luke discusses treating cancer with immunotherapy and another drug, such chemotherapy or targeted therapies, as well as what we know about biomarkers that predict if an immunotherapeutic will work.

Immunotherapy Forum Video #28: Doctors are still weighing the pros and cons of giving a cancer patient immunotherapy before or after resection surgery. In part 1 of 2 videos, Dr. Jason Luke details those risks and benefits.

Immunotherapy Forum Video #28: Doctors are still weighing the pros and cons of giving a cancer patient immunotherapy before or after resection surgery. In part 1 of 2 videos, Dr. Jason Luke details those risks and benefits.

Immunotherapy Forum Video #28: Doctors are still weighing the pros and cons of giving a cancer patient immunotherapy before or after resection surgery. In part 1 of 2 videos, Dr. Jason Luke details those risks and benefits.

Dr. Jared Weiss, University of North Carolina, discusses chemotherapy options and practice in late stage oropharynx cancer.

Dr. Jared Weiss, University of North Carolina, discusses chemotherapy options and practice in late stage oropharynx cancer.

Dr. Jared Weiss, University of North Carolina, discusses chemotherapy options and practice in late stage oropharynx cancer.

Dr. Jared Weiss, University of North Carolina, discusses chemotherapy options and practice in late stage oropharynx cancer.

Dr. Jared Weiss, University of North Carolina, discusses chemotherapy options and practice in late stage oropharynx cancer.

Dr. Jared Weiss, University of North Carolina, discusses chemotherapy options and practice in late stage oropharynx cancer.

Tue, 17 Dec 2013 12:00:00 +0100 https://edoc.ub.uni-muenchen.de/16476/ https://edoc.ub.uni-muenchen.de/16476/1/Ziegler_Katharina_M.pdf Ziegler, Katharina Melanie ddc:540, ddc:500, Fakultät für

Dr. David Spigel, Sarah Cannon Cancer Center, outlines treatment options for squamous lung cancer.

Dr. David Spigel, Sarah Cannon Cancer Center, outlines treatment options for squamous lung cancer.

Dr. David Spigel, Sarah Cannon Cancer Center, outlines treatment options for squamous lung cancer.

Dr. David Spigel, Sarah Cannon Cancer Center, outlines treatment options for squamous lung cancer.

Dr. David Spigel, Sarah Cannon Cancer Center, outlines treatment options for squamous lung cancer.

Dr. David Spigel, Sarah Cannon Cancer Center, outlines treatment options for squamous lung cancer.

Hypomagnesemia and hypocalcemia are common adverse events during cetuximab treatment. The influence of the chemotherapeutic combination on serum levels is unknown and the predictive value is currently under discussion. This analysis investigated 79 patients who had received cetuximab for at least 6 weeks in the day clinic of the Comprehensive Cancer Center, University of Munich. Calcium and magnesium serum levels were analyzed weekly; tumor response and adverse events were followed. Thirty-eight patients had metastatic colorectal cancer (mCRC) and the predictive value of hypomagnesemia was tested in these patients. During therapy, calcium serum levels decreased to about 97% of the baseline levels and were maintained for the duration of treatment. Magnesium levels showed a significant time-dependent decrease. Serum levels of magnesium were lower when cetuximab was combined with a platinum derivative. After a treatment duration of 12 weeks, magnesium levels decreased to 70% in platinum-treated patients, whereas they decreased to only 90% of baseline in patients who did not receive platinum therapy. In patients treated for mCRC, a decrease of serum magnesium below 95% of the baseline levels 14 days after initiating treatment separated patients significantly in terms of survival times. Magnesium levels decrease in a time-dependent manner during cetuximab therapy. As hypomagnesemia was more prominent in patients receiving platinum agents, magnesium measurements may be advised in these patients. In mCRC patients treated with cetuximab, day-14 magnesium serum levels correlated with treatment efficacy.

Dr. Jared Weiss from the University of North Carolina, reviews several options as induction therapy for head and neck cancer and focuses on the potential appeal and tolerability of the combination of weekly carboplatin and paclitaxel with cetuximab.

Dr. Jared Weiss from the University of North Carolina, reviews several options as induction therapy for head and neck cancer and focuses on the potential appeal and tolerability of the combination of weekly carboplatin and paclitaxel with cetuximab.

Dr. Jared Weiss from the University of North Carolina, reviews several options as induction therapy for head and neck cancer and focuses on the potential appeal and tolerability of the combination of weekly carboplatin and paclitaxel with cetuximab.

Dr. Jared Weiss from the University of North Carolina, reviews several options as induction therapy for head and neck cancer and focuses on the potential appeal and tolerability of the combination of weekly carboplatin and paclitaxel with cetuximab.

Dr. Jared Weiss from the University of North Carolina, reviews several options as induction therapy for head and neck cancer and focuses on the potential appeal and tolerability of the combination of weekly carboplatin and paclitaxel with cetuximab.

Dr. Jared Weiss from the University of North Carolina, reviews several options as induction therapy for head and neck cancer and focuses on the potential appeal and tolerability of the combination of weekly carboplatin and paclitaxel with cetuximab.

Dr Volke Heinemann talks to ecancer managing editor, Prof Gordon McVie, at ASCO 2013 about the German phase III clinical trial FIRE-3. The study found that first-line cetuximab plus FOLFIRI chemotherapy (folinic acid, fluorouracil, irinotecan) offers a roughly four-month survival advantage for patients with metastatic colorectal cancer, compared with bevacizumab plus FOLFIRI. The targeted drugs cetuximab and bevacizumab, both in combination with chemotherapy, are approved and commonly used as initial therapy. Until this study, it had been unclear which approach is better for patients with non-mutated forms of the KRAS gene.

Dr. Natasha Leighl, Princess Margaret Hospital in Toronto, Canada, reviews new data supporting new treatment options for EGFR mutation-positive patients with advanced NSCLC being newly treated or developing acquired resistance to prior EGFR inhibitors.

Dr. Natasha Leighl, Princess Margaret Hospital in Toronto, Canada, reviews new data supporting new treatment options for EGFR mutation-positive patients with advanced NSCLC being newly treated or developing acquired resistance to prior EGFR inhibitors.

Dr. Natasha Leighl, Princess Margaret Hospital in Toronto, Canada, reviews new data supporting new treatment options for EGFR mutation-positive patients with advanced NSCLC being newly treated or developing acquired resistance to prior EGFR inhibitors.

Dr. Natasha Leighl, Princess Margaret Hospital in Toronto, Canada, reviews new data supporting new treatment options for EGFR mutation-positive patients with advanced NSCLC being newly treated or developing acquired resistance to prior EGFR inhibitors.

Dr. Natasha Leighl, Princess Margaret Hospital in Toronto, Canada, reviews new data supporting new treatment options for EGFR mutation-positive patients with advanced NSCLC being newly treated or developing acquired resistance to prior EGFR inhibitors.

Dr. Natasha Leighl, Princess Margaret Hospital in Toronto, Canada, reviews new data supporting new treatment options for EGFR mutation-positive patients with advanced NSCLC being newly treated or developing acquired resistance to prior EGFR inhibitors.

Thu, 14 Mar 2013 12:00:00 +0100 https://edoc.ub.uni-muenchen.de/15544/ https://edoc.ub.uni-muenchen.de/15544/1/Kapaun_Christine.pdf Kapaun, C

Prof Ducreux talks to ecancertv about data in metastatic colorectal cancer (mCRC) presented for the first time at the ESMO 14th World Congress on Gastrointestinal Cancer in Barcelona. First, he discusses the negative results of the FUTURE trial, an open-label, randomised, phase II trial of FOLFOX4 plus cetuximab versus UFOX plus cetuximab as first-line treatment for mCRC. He also highlights the “disappointing” results of the phase III PETACC8 trial, which looked at the use of cetuximab in addition to FOLFLOX4 in the adjuvant mCRC setting. These data add to previous negative results seen in the adjuvant setting. Prof Ducreux also comments on the general use and choice of molecularly targeted agents for mCRC.

Colorectal Cancer

Dr Bauchner, Editor in Chief of JAMA, provides summary and commentary on the April 4, 2012 issue of JAMA, the Journal of the American Medical Association. Cetuximab and Stage III Colon Cancer Survival, Screening Ultrasound or MRI for Breast Cancer, Diagnostic Coding and Trends in Pneumonia Outcomes, Fluoroquinolones and Risk of Retinal Detachment, Management of Ovarian Cancer, Financial incentives in health care, Individualized breast cancer treatment.

This podcast reviews a negative phase III clinical trial of cetuximab combined with chemotherapy in first-line metastatic colorectal cancer and focuses on the interaction of targeted therapy combined with chemotherapy.

Q and A session with Dr. Jared Weiss, Medical Oncologist at UNC-Chapel Hill, about highlights in lung cancer in 2011.

Q and A session with Dr. Jared Weiss, Medical Oncologist at UNC-Chapel Hill, about highlights in lung cancer in 2011.

Dr. Jared Weiss, Medical Oncologist at UNC-Chapel Hill, reviews lung cancer highlights in 2011, focusing here on treatments focusing on the EGFR axis.

Dr. Jared Weiss, Medical Oncologist at UNC-Chapel Hill, reviews lung cancer highlights in 2011, focusing here on treatments focusing on the EGFR axis.

Purpose: This study investigated the impact of specific mutations in codon 12 of the Kirsten-ras (KRAS) gene on treatment efficacy in patients with metastatic colorectal cancer (mCRC). Patients: Overall, 119 patients bearing a KRAS mutation in codon 12 were evaluated. All patients received cetuximab-based first-line chemotherapy within the Central European Cooperative Oncology Group (CECOG), AIO KRK-0104 or AIO KRK-0306 trials. Results: Patients with KRAS codon 12 mutant mCRC showed a broad range of outcome when treated with cetuximab-based first-line regimens. Patients with tumors bearing a KRAS p.G12D mutation showed a strong trend to a more favorable outcome compared to other mutations (overall survival 23.3 vs. 14-18 months; hazard ratio 0.66, range 0.43-1.03). An interaction model illustrated that KRAS p.G12C was associated with unfavorable outcome when treated with oxaliplatin plus cetuximab. Conclusion: The present analysis suggests that KRAS codon 12 mutation may not represent a homogeneous entity in mCRC when treated with cetuximab-based first-line therapy. Copyright (C) 2012 S. Karger AG, Basel

Cetuximab ist ein monoklonaler Antikörper, der zunehmend in der Krebstherapie eingesetzt wird. Die typischste Nebenwirkung ist ein steriles makulo-papulöses Exanthem, das in vielen Studien positiv mit der Prognose korreliert. Auf die Therapie mit Cetuximab spricht jedoch nur ein begrenzter Anteil der Patienten an. Aufgrund der Nebenwirkungen und der nicht unerheblichen Kosten der Therapie wäre es von Interesse im Vorfeld die Patienten einzugrenzen, die am meisten von der Therapie profitieren. Ein Biomarker, der es erlaubt, vor Beginn der Therapie mit Cetuximab die Wirksamkeit der EGF-Rezeptor Inhibition bei einzelnen Patienten vorherzusagen, war bislang nicht bekannt. Das Exanthem, das in vielen Studien mit der Prognose korreliert, tritt erst einige Tage bis Wochen nach Behandlungsbeginn auf und ist daher als Entscheidungshilfe für oder gegen eine Cetuximab-Therapie ungeeignet. Bei dem Exanthem handelt es sich um eine sterile Entzündung und damit um ein immunologisches Geschehen. So entstand der Ansatz, einen immunologischen Marker zu suchen, der vor Therapiebeginn Aufschluss über die Wirksamkeit von Cetuximab bei unterschiedlichen Patienten geben kann. Für die vorliegende Arbeit wurden bei Cetuximab-behandelten Patienten Subpopulationen von Lymphozyten und dendritischen Zellen in Blut und Haut und antimikrobielle Peptide in der Haut durchflusszytometrisch und immunhistochemisch untersucht und mit gesunden Kontrollpersonen und Patienten unter einer Standard-Chemotherapie verglichen. Diese immunbiologischen Parameter wurden außerdem auf einen Zusammenhang mit Exanthemstärke und dem Therapieansprechen untersucht. Im Rahmen unserer Untersuchungen war es uns möglich, das Cetuximab-induzierte Exanthem näher zu charakterisieren. Das Zellinfiltrat wird epidermal durch immigrierte IDEC und regulatorische T-Zellen, dermal durch T-Helferzellen und Memory-Zellen dominiert. Zusätzlich treten plasmazytoide dendritische Zellen auf. Epidermal ist die Expression von humanem β-Defensin 2 erhöht. Der negative Zusammenhang zwischen der Anzahl dermaler zytotoxischer T-Zellen und dem Schweregrad des Exanthems ist ein Hinweis, dass es sich bei der Genese des Cetuximab-induzierten Exanthems nicht um eine Typ IV Immunreaktion handeln könnte. Unsere Untersuchungen im Blut haben keine Ergebnisse erbracht, die allein auf die Therapie mit Cetuximab zurückzuführen wären und als Biomarker für die biologische Wirksamkeit des Cetuximab verwendet werden könnten. Manche Veränderungen, wie die Induktion der CD11c+CD1a+ myeloiden dendritischen Zellen im Blut, korrelieren mit der Exanthemausprägung und sind auf das generalisierte Cetuximab-induzierte Exanthem zurückzuführen. Ergebnisse anderer Studien, die eine Zunahme der regulatorischen T-Zellen bei Tumorpatienten als negativen prognostischen Faktor etabliert haben, wurden durch unsere Untersuchungen bestätigt. In der Mehrzahl der klinischen Studien korreliert das Auftreten des Exanthems positiv mit der Prognose. Die Untersuchungsergebnisse zum Zusammenhang zwischen Exanthemausprägung und der Überlebensdauer sind hingegen zwiespältig. In unsere Studie wurden ausschließlich Patienten mit Cetuximab-induziertem Exanthem eingeschlossen. Die Ausprägung des Exanthems korrelierte in unseren Unter-suchungen nicht mit dem Tumoransprechen. Nach neueren Untersuchungen kann eine fehlende Korrelation zwischen Hautexanthem und Therapieansprechen auf Cetuximab mit Unterschieden im Dimerisationsstatus und im Dimerisationspartner des EGF-Rezeptors in der Haut und im Tumorgewebe zusammenhängen. Auf Keratinozyten übernehmen mehrheitlich EGF-Rezeptor Homodimere die Liganden-vermittelte Signalweiterleitung, während diese im Tumorgewebe von anderen EGFR-Heterodimeren vermittelt wird. Die Ergebnisse der Korrelationsanalysen zwischen Exanthemausprägung und dem Tumoransprechen in der Literatur stellen jedoch meist keine Korrelation zwischen Exanthemausprägung und dem Therapieansprechen her. Zusätzlich wurden die von uns erhobenen Daten an einem besonderen Patientenkollektiv erhoben. Ein systematischer Fehler aufgrund der Rekrutierungsbedingungen kann nicht ausgeschlossen werden. Ein Zusammenhang zwischen einem Auftreten des Exanthems und dem Therapieansprechen kann daher aufgrund des hier erhobenen Datenmaterials nicht beurteilt werden, da wir nur Patienten mit bestehendem Exanthem in unsere Studie eingeschlossen haben. Zusammenfassend lässt sich sagen, dass die von uns untersuchten immunologischen Parameter keinen neuen prädiktiven Wert für das Auftreten des Exanthems oder das Ansprechen auf Cetuximab erbracht haben. In der Literatur ist neben dem negativen K-Ras-Status bisher kein Biomarker beschrieben, der das Ansprechen auf Cetuximab zuverlässig vorhersagen würde.

December issue highlights, including mammography screening for younger women with familial breast cancer.

This slide presentation by Dr. Alan Sandler, medical oncologist and Division Chief of Hematology/Oncology at Oregon Health and Science University, provides an introduction to our current first line treatment options for metastatic NSCLC.

This slide presentation by Dr. Alan Sandler, medical oncologist and Division Chief of Hematology/Oncology at Oregon Health and Science University, provides an introduction to our current first line treatment options for metastatic NSCLC.

Aus der Reihe: Top News aus der Medizinischen Forschung

BARCELONA, SPAIN—Adding cetuximab to gemcitabine/oxaliplatin (GEMOX) chemotherapy controlled disease among two thirds of patients with advanced biliary cancer in a trial reported at the World Congress on Gastrointestinal Cancer. Éveline Boucher from the Centre Eugene Marquis, in Rennes, France, presented preliminary findings from a phase II open-label study among 101 patients who had not already received palliative treatment for their advanced biliary cancers, and had WHO performance status 0-1. She discussed her team’s findings with Peter Goodwin.

11th Annual Palm Beach Cancer Symposium (April 3-4, 2009 Hollywood, Florida)—Peter Goodwin interviews John Macdonald, Chief Medical Officer of Aptium Oncology in Los Angeles about his data on the relevance of KRAS tumor status to the choice of molecular therapy for patients with metastatic colorectal cancer. Whether the gene is wild-type or mutant determines sensitivity of the tumor to anti-epidermal growth factor or anti-vascular endothelial growth factor receptor therapy. Dr Macdonald also discusses the disappointing finding that blocking both of these proliferation pathways does not lead to improved efficacy when two targeted drugs are used in combination.

Éveline Boucher of Centre Eugene Marquis in France on the encouraging preliminary results of her Phase II open-label study of 101 patients reported at the ESMO World Congress on Gastrointestinal Cancer

Éveline Boucher of Centre Eugene Marquis in France on the encouraging preliminary results of her Phase II open-label study of 101 patients reported at the ESMO World Congress on Gastrointestinal Cancer

Interviewed at the Palm Beach Cancer Symposium, John Macdonald, Chief Medical Officer of Aptium Oncology in Los Angeles, talks about his latest data on the relevance of KRAS tumor status—i.e., whether the gene is wild-type or mutant determines the sensitivity of the tumor to anti-EGF or anti-VEGF receptor therapy. He also discusses the disappointing finding that blocking both of these proliferation pathways does not lead to improved efficacy when two targeted drugs are used in combination.

Interviewed at the Palm Beach Cancer Symposium, John Macdonald, Chief Medical Officer of Aptium Oncology in Los Angeles, talks about his latest data on the relevance of KRAS tumor status—i.e., whether the gene is wild-type or mutant determines the sensitivity of the tumor to anti-EGF or anti-VEGF receptor therapy. He also discusses the disappointing finding that blocking both of these proliferation pathways does not lead to improved efficacy when two targeted drugs are used in combination.

Robert Pirker discusses the research article about the human monoclonal antibody cetuximab in the treatment of lung cancer.

Background: Irinotecan-based second-line chemotherapy of metastatic colorectal cancer (CRC) is effective, it might, however, be contraindicated in cases of severe liver dysfunction due to advanced liver metastases. Case Report: A 57-year-old woman with diffuse CRC liver metastases showed progressive disease on first-line treatment with capecitabine and oxaliplatin (XELOX). Chronic cholestasis and hyperbilirubinemia caused by advanced liver involvement prohibited second-line treatment with irinotecan-based chemotherapy. We initiated combined antibody treatment with cetuximab and bevacizumab. Results: Clinical performance status as well as laboratory parameters improved rapidly. Staging investigations after 8 weeks revealed a partial remission. Since bilirubin levels had returned to the upper limit of normal, therapy could be changed to standard irinotecan, 5-fluorouracil, folinic acid, and bevacizumab. Conclusion: Combined treatment with cetuximab and bevacizumab may be considered as an effective treatment option in patients who cannot be treated with standard chemotherapy regimens due to impaired liver metabolism of cytotoxic substances.

Efficacy and Tolerability of Panitumumab and Cetuximab

Efficacy and Tolerability of Panitumumab and Cetuximab

Efficacy and Tolerability of Panitumumab and Cetuximab