Clinical observation of cetuximab in conversion therapy of patients with unresectable colorectal liver-limited metastases

Objective To investigate the effcacy and safety of cetuximab combined with chemotherapy for patients with KRAS Wild-Type unresectable colorectal liver-limited metastases and explore the factors that may affect the prognosis. Methods Clinical data of 18 patients with KRAS Wild-Type unresectable colorectal liver-limited metastases admitted to our hospital from May 2007 to May 2012 were collected and all patients were treated with cetuximab combined with chemotherapy with the effcacy evaluating as CR+PR+SD. Then they accepted lesion resection of the primary tumor, and simultaneously accepted lesion resection of the metastases partially. The effcacy and safety of conversion therapy were summarized and assessed, and the relationship between clinicopathology features and outcome were retrospectively analyzed. Results The median duration treatment of cetuximab was 12 weeks, with CR in 0 case, PR in 11 cases. All patients received surgery after conversion therapy, 11 of them underwent synchronous radical colorectal surgery and liver metastases resection, 7 of them received local treatment of metastases. In the 18 patients, recurrent metastases occurred in 12 cases and death in 5 cases. Median PFS (progression-free survival) was 20.8 months, and the OS was 9.59 -37.13 months. Univariate analysis showed that the number, size and location of liver metastases, serum CEA concentration, early tumor response were related to the PFS with signifcant differences (P< 0.05). Conclusion Cetuximab combined chemotherapy can improve R0 resection rate of the primary tumor and metastases with effcacy and safeness for paients with KRAS Wild-Type unresectable colorectal liver-limited metastases.