Copyright
©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
Revisiting oral fluoropyrimidine with cetuximab in metastatic colorectal cancer: Real-world data in Chinese population
Ka-On Lam, Man-Chi Fu, Kin-Sang Lau, Kam-Mo Lam, Cheuk-Wai Choi, Wan-Hang Chiu, Cheng-Man Yuen, Lai-Han Kwok, Fong-Kit Tam, Wing-Lok Chan, Sum-Yin Chan, Pui-Ying Ho, To-Wai Leung, Ho-Fun Lee
Ka-On Lam, Man-Chi Fu, Cheuk-Wai Choi, Wing-Lok Chan, Ho-Fun Lee, Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
Ka-On Lam, Kin-Sang Lau, Wing-Lok Chan, Sum-Yin Chan, Pui-Ying Ho, To-Wai Leung, Ho-Fun Lee, Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China
Ka-On Lam, Ho-Fun Lee, Clinical Oncology Centre, The University of Hong Kong- Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
Kam-Mo Lam, Cheng-Man Yuen, Lai-Han Kwok, Fong-Kit Tam, Department of Pharmacy, Queen Mary Hospital, Hong Kong, China
Wan-Hang Chiu, Department of Diagnostic Radiology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
Author contributions: Lam KO, Fu MC, Lau KS, Lau KM, and Leung TW designed the study; Lam KO, Lau KS, Lam KM, Choi CW, Chiu WH, Yuen CM, Kwok LH, Tam FK, Chan WL, Chan SY, and Ho PY acquire and analysed the data; Lam KO, Fu MC, Lau KS, Choi CW, Chiu WH,Leung TW, and Lee HF interpreted the data; all authors were involved in drafting the article and making critical revisions and final approval of the version of the article to be published.
Institutional review board statement: This study was approved by the institutional review board (HKU/HA HKW IRB UW 15-315).
Informed consent statement: Informed consent was waived by the institutional review board because this is a retrospective study.
Conflict-of-interest statement: Lam KO received research grants from Bayer, Roche, and Taiho, and was on advisory boards/received honorarium from Amgen, Bayer, BMS, Eli Lilly, Merck, MSD, Roche, Sanofi-Aventis, and Taiho. All other authors declare no conflict of interest.
STROBE statement: The authors have read the STROBE statement-checklist of items, and the manuscript was prepared and revised according to the STROBE statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ka-on Lam, MBBS, Clinical Assistant Professor, Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 1/F, Professorial Block, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China. lamkaon@hku.hk
Telephone: +852-22554352 Fax: +852-28726426
Received: June 4, 2019
Peer-review started: June 6, 2019
First decision: August 23, 2019
Revised: September 7, 2019
Accepted: September 13, 2019
Article in press: September 13, 2019
Published online: November 15, 2019
ARTICLE HIGHLIGHTS
Research background
Although cetuximab is shown to provide survival benefits in patients with RAS wild-type metastatic colorectal cancer, little is known about the optimal chemotherapy backbone for cetuximab except that oral fluoropyrimidine appeared to be inferior to infusional fluoropyrimidine and is not recommended in various international guidelines.
Research motivation
Before the evidence of the inferiority of oral fluoropyrimidine combining with cetuximab, it was commonly used due to convenience and cost effectiveness. The inferiority of oral fluoropyrimidine was not readily observed in our previous experience. In addition, research has shown that there might be a regional difference in the tolerability of oral fluopyrimidine. The inferiority of oral fluopyrimidine demonstrated in previous studies might not be applicable to our locality with Chinese population.
Research objectives
This study would like to compare oral fluoropyrimidine with infusional fluoropyrimidine in combination with cetuximab in Chinese population in terms of progression-free survival and overall survival.
Research methods
A retrospective cohort study was employed to compare and contrast the survival and adverse effect profile of oral fluoropyrimidine (FP) and infusional FP in combination with cetuximab in Chinese population in the real-world setting.
Research results
There was no significant difference in median progression-free survival and median overall survival between the two groups. The incidence of various grade 3 or above adverse effects was similar in both groups.
Research conclusions
Oral and infusional fluoropyrimidine has comparable efficacy and safety profiles when used with cetuximab.
Research perspectives
Oral fluoropyrimidine may be a good alternative to infusional fluoropyrimidine when in combination with cetuximab.
