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FCGR polymorphisms and cetuximab efficacy in chemorefractory metastatic colorectal cancer: An international consortium study

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Geva, Ravit Vecchione, Loredana Kalogeras, Konstantinos T. Jensen, Benny Vittrup Lenz, Heinz-Josef Piessevaux, Hubert [UCL] Tejpar, Sabine

Objective We aimed to better clarify the role of germline variants of the FCG2 receptor, FCGR2A-H131R and FCGR3A-V158F, on the therapeutic efficacy of cetuximab in metastatic colorectal cancer (mCRC). A large cohort with sufficient statistical power was assembled. Design To show a HR advantage of 0.6 in progression-free survival (PFS) for FCGR2A-HH versus the rest and FCGR3A-VV versus the rest, with an 80% power, 80 Kirsten Rat Sarcoma Viral Oncogene Homolog (KRAS) wild-type (KRAS-WT) and 52 KRAS-WT patients are required, respectively. This leads to a total sample size of 952 and 619 patients, respectively. Samples were collected from 1123 mCRC patients from 15 European centres treated with cetuximab alone or in combination with chemotherapy. Fc gamma receptor (FCGR) status was centrally genotyped. Two additional externally genotyped series were included. Results: Incidences of FCGR2A-HH and FCGR3A-VV in KRAS-WT patients were 220/660 (33%) and 109/676 (16.1%) respectively. There was no difference in median PFS (mPFS) for KRAS-WT patients with FCGR2A-HH (22.0 weeks; 95% CI18.8 to 25.2) versus non-HH (22.0 weeks; 95% CI 19.4 to 24.6) or for FCGR3A-VV (16.4 weeks; 95% CI 13.0 to 19.8) versus non-VV (23 weeks; 95% CI 21.1 to 24.9) (p=0.06). Median overall survival, response rate and disease control rate assessments showed no benefit for either HH or VV. Conclusions: No differences in mPFS were found between the FCGR polymorphisms HH and the others and VV versus the others in KRAS-WT mCRC patients refractory to irinotecan, oxaliplatin and 5-fluorouracil treated with cetuximab. We cannot confirm the effects of other IgG1 antibodies, which may be weaker than previously suggested. Other markers may be needed to study the actual host antibody response to cetuximab.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2015
Language Anglais
Journal information "Gut" - Vol. 64, no. 6, p. 921-928 (2015)
Peer reviewed yes
Publisher B M J Group ((United Kingdom) London)
issn 0017-5749
e-issn 1468-3288
Publication status Publié
Affiliations UCL - (SLuc) Service d'hépato-gastro-entérologie
UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie
Keywords Antibody Targeted Therapy ; Colorectal Cancer ; Genetic Polymorphisms ; Immune Response
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Bibliographic reference Geva, Ravit ; Vecchione, Loredana ; Kalogeras, Konstantinos T. ; Jensen, Benny Vittrup ; Lenz, Heinz-Josef ; et. al. FCGR polymorphisms and cetuximab efficacy in chemorefractory metastatic colorectal cancer: An international consortium study. In: Gut, Vol. 64, no. 6, p. 921-928 (2015)
Permanent URL http://hdl.handle.net/2078.1/164360