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Title: Cetuximab Approved in Japan for Treatment of Metastatic Colorectal Cancer
URL: http://www.pslgroup.com/dg/225DE2.htm
Doctor's Guide
July 16, 2008


NEW YORK -- July 16, 2008 -- Marketing authorisation has been granted in Japan for the use of cetuximab (Erbitux) in treating patients with epidermal growth factor receptor (EGFR)-positive, curatively unresectable, advanced or recurrent colorectal cancer (CRC).

On the basis of the submitted data, the label allows the use of Erbitux plus irinotecan in second- and further lines of metastatic CRC (mCRC).

The Japanese submission was mainly based on data from 6 different studies which included 2 international phase 3 studies -- National Cancer Institute of Canada Clinical Trial Group CO.17 (NCIC CTG CO.17) study and the European Prospective Investigation of Cancer (EPIC) study.

The NCIC CTG CO.17 phase 3 study involved 572 patients whose mCRC had progressed with all available standard chemotherapies. The study demonstrated that treating patients with cetuximab as a monotherapy improved overall median survival time by 32% -- 6.1 months with cetuximab compared with 4.6 months with best supportive care alone.

The EPIC study involved 1,298 patients with mCRC whose cancer had progressed on first-line treatment with oxaliplatin-based chemotherapy. Patients were treated with either cetuximab plus irinotecan-based chemotherapy or irinotecan-based chemotherapy alone.

Overall survival did not differ significantly between the 2 trial arms. However, this may have been because almost half of the patients in the control arm received cetuximab plus irinotecan as post-study treatment after failing irinotecan therapy.

Patients in the cetuximab-plus-irinotecan-based chemotherapy arm had significantly longer progression-free survival (4.0 months vs 2.6 months, P < .0001) compared with patients in the irinotecan-based chemotherapy alone arm. Response rates were also higher for patients treated with cetuximab (16.4% vs 4.2%, P < .0001).

The most commonly reported side effect with cetuximab is an acne-like skin rash that seems to be correlated with a good response to therapy. In approximately 5% of patients, hypersensitivity reactions may occur during treatment with cetuximab and about half of these reactions are severe.

SOURCE: Merck

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