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  • PIK3CA Pathway Mutations Pr...
    de la Rochefordiere, Anne; Kamal, Maud; Floquet, Anne; Thomas, Laurence; Petrow, Peter; Petit, Thierry; Pop, Marius; Fabbro, Michel; Kerr, Christine; Joly, Florence; Sevin, Emmanuel; Maillard, Sophie; Curé, Hervé; Weber, Béatrice; Brunaud, Claire; Minsat, Mathieu; Gonzague, Laurence; Berton-Rigaud, Dominique; Aumont, Maud; Gladieff, Laurence; Peignaux, Karine; Bernard, Virginie; Leroy, Quentin; Bieche, Ivan; Margogne, Audrey; Nadan, AnaTereza; Fourchotte, Virginie; Diallo, Alhassane; Asselain, Benard; Plancher, Corine; Armanet, Sébastien; Beuzeboc, Philippe; Scholl, Suzy M

    Clinical cancer research, 06/2015, Letnik: 21, Številka: 11
    Journal Article

    EGFR is frequently overexpressed in cervical cancer, suggesting EGFR blockade as a promising treatment approach. Cetuximab, an anti EGFR antibody, used conjointly with radiochemotherapy, was feasible in first-line treatment of cervix carcinoma limited to the pelvis. This randomized phase II trial enrolled 78 FIGO stage IB2-IIIB cervical cancer patients to either cisplatin-based radiochemotherapy alone (arm B, n = 38) or conjointly with a 6-week course of weekly cetuximab (arm A, n = 40). Brachytherapy was given to the pelvic mass. Primary endpoint was disease-free survival (DFS) at 2 years. EGFR expression and targeted sequencing were performed in 54 of 78 patients. Cetuximab over a 6-week period did not improve DFS at 24 months. At 31 months median follow-up, DFS was not significantly different (P = 0.18). Complete response at 4 to 6 months was strongly predictive for excellent DFS (log-rank test; P < 0.001). PIK3CA, KRAS, and STK11 mutations were observed in 22%, 4%, and 2% of patients, respectively. No tumor with a PI3K pathway mutation showed complete response (0/8 in arm A and 0/6 in arm B), whereas 14 of 52 (27%) tumors without mutations did (P = 0.021). PI3K pathway-mutated tumors showed a trend toward poorer DFS (P = 0.06) following cetuximab (8/22) as compared with those following standard treatment only (6/18). Similar to patients with head and neck cancer, patients with cervical cancer showed no gain in DFS at 2 years following a combined treatment of cetuximab with radiochemotherapy. Although treatment tolerance and compliance were satisfactory, it remains to be demonstrated whether maintenance therapy with cetuximab could be beneficial in selected patient groups.