Canadian Cancer Trials Group Bulletins


Recent Article Related to Canadian Cancer Trials Group CO.17

A recent article published in the Journal of the American Medical Association has found that cetuximab use was associated with longer overall and progression-free survival among patients with chemotherapy-refractory colorectal cancer with p.G13D-mutated tumours than with other KRAS-mutated tumours.

De Roock W, Jonker DJ, Di Nicolantonio F, Sartore-Bianchi A, Tu D, Siena S, Lamba S, Arena S, Frattini M, Piessevaux H, Van Cutsem E, O'Callaghan CJ, Khambata-Ford S, Zalcberg JR, Simes J, Karapetis CS, Bardelli A, Tejpar S. Association of KRAS p.G13D Mutation With Outcome in Patients With Chemotherapy-Refractory Metastatic Colorectal Cancer Treated With Cetuximab. JAMA. 2010;304:1812-1820.

These results are from a pooled analysis of 579 patients with chemotherapy-refractory colorectal cancer treated with cetuximab between 2001 and 2008, and included 195 patients enrolled on the Canadian Cancer Trials Group CO.17 trial -- A Phase III Randomized Study of Cetuximab and Best Supportive Care versus Best Supportive Care in Patients with Pretreated Metastatic Epidermal Growth Factor Receptor (EGFR) - Positive Colorectal Carcinoma.

The article furthers results of Karapetis et al (Karapetis CS, Khambata-Ford S, Jonker DJ, O'Callaghan CJ, Tu D, Tebbutt NC, Chalchal H, Shapiro JD, Robitaille S, Price TJ, Shepherd L, Au H-J, Langer C, Moore MJ, Zalcberg JR. K-ras mutations and benefit from cetuximab in advanced colorectal cancer. N Engl J Med 359: 1757-65, 2008) which found that cetuximab neither slowed cancer growth nor lengthened survival in patients with tumours carrying mutated KRAS genes.

The JAMA article concluded by suggesting that evaluation of cetuximab therapy in patients with p.G13D-mutated tumours in prospective randomized trials may be warranted.