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01-08-2016 | Original Article

Panitumumab in combination with irinotecan plus S-1 (IRIS) as second-line therapy for metastatic colorectal cancer

Authors: Toshi Takaoka, Tetsuo Kimura, Rai Shimoyama, Shunji Kawamoto, Kazuki Sakamoto, Fuminori Goda, Hiroshi Miyamoto, Yuji Negoro, Akihito Tsuji, Koji Yoshizaki, Takahiro Goji, Shinji Kitamura, Hiromi Yano, Koichi Okamoto, Masako Kimura, Toshiya Okahisa, Naoki Muguruma, Yoshiro Niitsu, Tetsuji Takayama

Published in: Cancer Chemotherapy and Pharmacology | Issue 2/2016

Abstract

Background

Irinotecan plus S-1 (IRIS) is the only oral fluoropyrimidine-based regimen reported to be non-inferior to FOLFIRI and widely used in clinical practice for metastatic colorectal cancer (mCRC) patients. However, the combination of IRIS plus an anti-EGFR agent has not been evaluated previously. This study aimed to investigate the feasibility and efficacy of IRIS with panitumumab as second-line therapy for wild-type KRAS mCRC.

Methods

Main inclusion criteria were patients with wild-type KRAS mCRC refractory to one prior chemotherapy regimen for mCRC, ECOG PS 0–2, and age ≥20 years. Patients received panitumumab (6 mg/kg) and irinotecan (100 mg/m²) on days 1 and 15 and S-1 (40–60 mg according to body surface area) twice daily for 2 weeks, repeated every 4 weeks. The primary endpoint was the feasibility of the therapy. The secondary endpoints were response rate (RR), progression-free survival (PFS), and overall survival (OS).

Results

A total of 36 patients received protocol treatment in eight centers. Of these, 23 patients (63.9 %) completed protocol treatment, demonstrating achievement of the primary endpoint. The most frequent grade 3/4 toxicities were diarrhea (16.7 %), acne-like rash (13.9 %), and neutropenia (11.1 %). The overall RR was 33.3 % (12/36). Of these patients, five underwent conversion surgery. Median PFS and OS were 9.5 months (95 % CI 3.5–15.4 months) and 20.1 months (95 % CI 16.7–23.2 months), respectively.

Conclusion

IRIS plus panitumumab has an acceptable toxicity profile and a promising efficacy in patients with previously treated wild-type KRAS mCRC. Accordingly, this regimen can be an additional treatment option for second-line chemotherapy in wild-type KRAS mCRC.

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Title: Panitumumab in combination with irinotecan plus S-1 (IRIS) as second-line therapy for metastatic colorectal cancer
Authors: Toshi Takaoka
Tetsuo Kimura
Rai Shimoyama
Shunji Kawamoto
Kazuki Sakamoto
Fuminori Goda
Hiroshi Miyamoto
Yuji Negoro
Akihito Tsuji
Koji Yoshizaki
Takahiro Goji
Shinji Kitamura
Hiromi Yano
Koichi Okamoto
Masako Kimura
Toshiya Okahisa
Naoki Muguruma
Yoshiro Niitsu
Tetsuji Takayama
Publication date: 01-08-2016
Publisher: Springer Berlin Heidelberg
Published in: Cancer Chemotherapy and Pharmacology / Issue 2/2016
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI: https://doi.org/10.1007/s00280-016-3096-5

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