Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/11464
Title: Intermittent versus continuous erlotinib with concomitant modified "xELOX" (q3W) in first-line treatment of metastatic colorectal cancer : correlation with Serum Amphiregulin and transforming growth factor Alpha
Authors: Ma, BBY
Chan, SL
Ho, WM
Lau, W
Mo, F
Hui, EP
Chan, C
Poon, A
Dattatray, RD
Wong, SCC 
To, KF
King, AD
Ahuja, A
Chan, ATC
Keywords: Amphiregulin
Capecitabine
Erlotinib
Oxaliplatin
Transforming growth factor alpha
Issue Date: 2013
Publisher: John Wiley & Sons
Source: Cancer, 2013, v. 119, no. 23, p. 4145-4153 How to cite?
Journal: Cancer 
Abstract: BACKGROUND This study evaluated the activity of 2 schedules of erlotinib in combination with chemotherapy, and the prognostic significance of serum amphiregulin (AREG) and transforming growth factor alpha (TGFa) in metastatic colorectal cancer. METHODS A total of 60 untreated patients were randomized to a "continuous" (CON; erlotinib 100 mg daily) or an " intermittent" (INT; erlotinib 150 mg on alternate day on day 2 to 14, then 150 mg daily on days 15 to 21) schedule of erlotinib with a modified XELOX (capecitabine plus oxaliplatin) regimen. Serum levels of AREG and TGFa were determined serially. RESULTS Baseline characteristics were similar between the 2 arms. Of the 58 patients evaluated for response, there was a nonsignificant trend toward a slightly higher overall response rate in the INT arm (66.7%) versus the CON arm (56.7%). At a median follow-up of 2.8 years, the median overall survival was 18.8 months (95% confidence interval = 11.3-22.9 months) and 20.7 months (95% confidence interval = 12.5-31 months, P =.19) for the CON and INT arm, respectively. KRAS mutation did not predict drug response. The 2 arms did not differ significantly in toxicity. Baseline serum TGFa was an independent predictor of progression-free survival, whereas a drop in serum TGFa and AREG levels following 3 to 4 cycles of treatment were associated with shorter progression-free survival and overall survival, respectively. CONCLUSIONS The intermittent erlotinib schedule was associated with a higher response rate, although this is not statistically significant. Serum TGFa and AREG levels have prognostic significance in erlotinib-treated patients with colorectal cancer, and further studies are warranted.
URI: http://hdl.handle.net/10397/11464
ISSN: 0008-543X
DOI: 10.1002/cncr.28327
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