Compliance with TGA prescribing information - Weekly or second weekly cetuximab for the treatment of metastatic colorectal cancer
Journal Title
Internal Medicine Journal
Publication Type
epub ahead of print
BACKGROUND: Treatment with cetuximab provides a survival benefit for patients with RAS wild-type metastatic colorectal cancer (mCRC). Practice-defining cetuximab studies utilised weekly (q1w) administration. More convenient second weekly (q2w) administration is supported by pharmacokinetic data and a recent meta-analysis, but large head-to-head studies have not been conducted. TGA prescribing information states cetuximab be administered q1w for all indications. METHODS: We analysed data from a prospective mCRC database at 7 Melbourne hospitals from January 2010 to August 2019. Characteristics and outcomes for cetuximab treated patients were examined, comparing q1w versus q2w schedules. Progression free survival (PFS) and overall survival (OS) were the primary endpoints. RESULTS: Of 214 eligible patients, 103 (48%) received q1w and 111 (52%) received q2w cetuximab. Q2w cetuximab has been used in >70% of patients from 2015. Q2w was more commonly used in public patients (70% versus 13% in private, p < 0.001), in left-sided primary tumours (83% vs 68%, p = 0.025) and in combination with chemotherapy (73% q2w vs 40% q1w, p < 0.001). Q2w treatment was less common in BRAFV600E mutated tumours (4% vs 13%, p = 0.001). PFS was similar across all lines of therapy, including when analyses were limited to a left-sided primary and there was no difference in OS in multivariate analysis. CONCLUSION: This real-world analysis shows q2w cetuximab has become the dominant method of administration, despite TGA guidance. Our outcome data adds to other data supporting the use of q2w cetuximab as the standard option. Consideration could be given to modifying current TGA advice. This article is protected by copyright. All rights reserved.
Cetuximab; Egfr; RAS wild type; every second week; metastatic colorectal cancer
WEHI Research Division(s)
Personalised Oncology
PubMed ID
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Creation Date: 2022-06-17 09:28:51
Last Modified: 2022-06-17 09:53:43
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