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Anti-EGFR Therapy in Metastatic Small Bowel Adenocarcinoma: Myth or Reality?
Emanuela Dell'Aquila1, Tea Zeppola1, Marco Stellato1
1Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy.
Background:
Due to the relative rarity of small bowel adenocarcinoma (SBA), prospective trials, helping to guide therapeutic decisions, are lacking and the optimal therapy for advanced SBA is unknown. The role of targeted agents, such as anti-epidermal growth factor receptor (EGFR) and anti-vascular endothelial growth factor (VEGF), is unknown.
Patients And Methods:
This is a retrospective multicenter observational study that included patients with metastatic SBA treated with anti-EGFR antibodies (cetuximab or panitumumab) ± chemotherapy in the first (I) or second (II) line.
Results:
Thirteen patients with metastatic SBA, recruited from 5 Italian referral institutions, were included in the present retrospective analysis. All patients received anti-EGFR inhibitors as a single agent or in association with chemotherapy. More common G2 treatment-related side effects were skin reaction (8 patients, 53.8%), hypomagnesemia (6 patients, 46.2%), and diarrhea (8 patients, 61.5%). Grade 3 diarrhea was observed in only 1 patient. Conjunctivitis was not reported in any patients. Grade 4 toxicity was not reported. In the overall population, median progression-free survival was 5.526 months (95% confidence interval [CI]: 3.684-12.467). Median overall survival was 15.86 months (95% CI: 14.43-24.30). Complete response was observed in 15% of patients, partial response in 39% of patients, stable disease in 23% of patients, and progression disease in 15% of patients.
Conclusions:
In this retrospective analysis, anti-EGFR inhibitors showed to be a suitable addendum to chemotherapy in the I and II line, with an excellent tolerance and safety profile both in I and II line.
Insights
Anti-epidermal growth factor receptor (EGFR) inhibitors show promise as a chemotherapy addendum for advanced small bowel adenocarcinoma (SBA). This retrospective study found these targeted agents to be well-tolerated and effective in first and second-line treatment for metastatic SBA.
Area of Science:
- Oncology
- Gastroenterology
- Pharmacology
Background:
- Small bowel adenocarcinoma (SBA) is rare, leading to a lack of prospective trials and uncertainty regarding optimal therapy for advanced stages.
- The efficacy of targeted therapies, including anti-epidermal growth factor receptor (EGFR) and anti-vascular endothelial growth factor (VEGF) agents, in SBA remains largely unknown.
Purpose of the Study:
- To evaluate the safety and efficacy of anti-EGFR antibodies in patients with metastatic small bowel adenocarcinoma.
- To assess the role of anti-EGFR inhibitors as a first or second-line treatment option for advanced SBA.
Main Methods:
- A retrospective, multicenter observational study involving 13 patients with metastatic SBA.
- Patients received anti-EGFR antibodies (cetuximab or panitumumab) with or without chemotherapy as first or second-line treatment.
Main Results:
- The median progression-free survival was 5.5 months, and the median overall survival was 15.86 months.
- Common side effects included skin reactions (53.8%) and diarrhea (61.5%), with only one case of Grade 3 diarrhea. No Grade 4 toxicity was reported.
- Objective responses included 15% complete response and 39% partial response, with 23% stable disease.
Conclusions:
- Anti-EGFR inhibitors demonstrated a suitable addendum to chemotherapy for first and second-line treatment in advanced SBA.
- These targeted agents exhibited an excellent safety and tolerance profile in the studied patient population.
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