Panitumumab in combination with infusional oxaliplatin and oral capecitabine for conversion therapy in patients with colon cancer and advanced liver metastases: The MetaPan study

Francesco Leone, Salvatore Artale, Donatella Marino, Celeste Cagnazzo, Stefano Cascinu, Carmine Pinto, Giuseppe Fornarini, Marco Tampellini, Francesca Di Fabio, Andrea Sartore-Bianchi, Luciano De Carlis, Raffaele Pugliese, Lorenzo Capussotti, Luisa Gioeni, Salvatore Siena, Massimo Aglietta

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND Preoperative chemotherapy improves the outcome in patients with colorectal cancer with liver metastases. In the current study, the authors evaluated the activity of a conversion treatment with the combination of capecitabine plus oxaliplatin (XELOX) used in association with panitumumab in patients with unresectable, liver-only, metastatic colon cancer. METHODS Chemotherapy-naive patients with unresectable liver metastases from colon cancer with no other metastatic disease sites were enrolled. All patients received upfront therapy with XELOX plus panitumumab (P-XELOX) and were reevaluated for resectability every 4 cycles. The primary endpoint was the objective response rate (ORR). Secondary endpoints were overall survival (OS), progression-free survival, the percentage of patients whose disease became radically resectable, and the safety of the P-XELOX combination. RESULTS A total of 49 patients were recruited, 35 of whom had wild-type KRAS (wtKRAS) and 14 of whom (who were enrolled before study amendment) had unknown (9 patients) or mutated (5 patients) KRAS mutational status. Forty-six patients were evaluable for response. After conversion P-XELOX therapy, the ORR in the general population was 54%, with 2 complete responses, 23 partial responses, and 14 cases of stable disease. In patients with wtKRAS, the ORR of the patients reached 65% (2 CRs and 19 PRs), which allowed 15 patients with initial unresectable liver metastasis to be reclassified as having resectable disease. Survival analysis demonstrated a median progression-free survival of 8.5 months and a median OS of 21.9 months. Patients who underwent surgery were found to have a significantly better OS when compared with those who did not undergo surgery (P

Original languageEnglish
Pages (from-to)3429-3435
Number of pages7
JournalCancer
Volume119
Issue number19
DOIs
Publication statusPublished - Oct 1 2013

Keywords

  • capecitabine plus oxaliplatin (XELOX) chemotherapy
  • colon cancer
  • liver metastasis
  • liver resection
  • panitumumab

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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