The interference between oxaliplatin & anti-EGFR therapies: a different hypothesis to explain the 'unexplainable'

Per Med. 2018 Jul 1;15(4):319-327. doi: 10.2217/pme-2017-0082. Epub 2018 Jun 21.

Abstract

This paper has been written because we have a differing idea concerning the suspected negative interference between oxaliplatin and anti-EGFR therapies in cancer patients. Several multicenter, randomized, controlled clinical trials investigated whether the efficacy of oxaliplatin-based chemotherapy is improved by the addition of anti-EGFR therapies in patients affected by KRAS wild-type advanced colorectal cancer. Results of these trials have produced puzzling findings, with some studies demonstrating improved survival and other studies showing no differences in overall survival between experimental and control arms. Moreover, a detrimental effect has been demonstrated in some settings. Nevertheless, the extent of this interaction remains uncertain. Some physicians proposed personal interpretations. This paper describes our hypothesis.

Keywords: EGFR-expression; anti-EGFR; cetuximab; detrimental effect; microscopic disease; negative interference; oxaliplatin; panitumumab.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Cetuximab / therapeutic use
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / genetics
  • Drug Interactions
  • ErbB Receptors / antagonists & inhibitors
  • Humans
  • Multicenter Studies as Topic
  • Oxaliplatin / therapeutic use*
  • Panitumumab / therapeutic use
  • Precision Medicine
  • Protein Kinase Inhibitors / therapeutic use*
  • Proto-Oncogene Proteins p21(ras) / genetics*
  • Randomized Controlled Trials as Topic
  • Survival Analysis
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • KRAS protein, human
  • Protein Kinase Inhibitors
  • Oxaliplatin
  • Panitumumab
  • EGFR protein, human
  • ErbB Receptors
  • Proto-Oncogene Proteins p21(ras)
  • Cetuximab