Skin Disorders and Primary Tumor Location as Prognostic Factors in Patients with Metastatic Colorectal Cancer Treated with Cetuximab and Chemotherapy

Document Type: Research Articles

Authors

1 Department of Pharmacy, National Hospital Organization Hokkaido Cancer Center, Japan.

2 Department of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, Japan.

Abstract

Background: Cetuximab-induced skin disorder is common in colorectal cancer (CRC), and is known to affect
prolonged overall survival (OS). Patients with left-sided CRC survive longer than those with right-sided CRC, among
those treated with combination cetuximab and chemotherapy. However, no study has evaluated patient prognosis
in terms of OS and progression-free survival (PFS) in relation to both tumor location and skin disorder. This study
aimed to determine the incidence of skin disorder according to tumor location and analyze the relationship of tumor
location and skin disorder with OS. Methods: Patients with metastatic colorectal cancer (mCRC) treated with standard
chemotherapy and cetuximab as first-line therapy were included. Differences in the incidence of skin disorders due to
the location of the primary tumors were compared in the same patient. The OS and PFS in relation to the location of
the primary tumors and presence or absence of skin disorder were also compared. Results: Total frequency of each
skin disorder as rash acneiform, paronychia, and dry skin in patients with left- and right-sided mCRC was 70%, 70%,
and 43% and 27%, 36%, and 27%, respectively. The median OS was 8.9 months for mCRC on the left-sided without
skin disorder and 56.3 months for mCRC on the left-sided with skin disorder. In comparison, the median OS was 10.4
months for mCRC on the right-sided without skin disorder and 11.3 months for mCRC on the right-sided with skin
disease (left-sided with skin disorder versus other three group; P<0.001). Conclusions: Primary tumor location and
the presence of skin disorder are important factors in patients with mCRC who receive cetuximab. In particular, our
results show the new fact that the left-sided and right-sided mCRC survival time were comparable if there is no skin
disorder caused by cetuximab.

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