Imagine a cure that should not be administered every day and following a very precise dosage, but rather as needed or better according to the specific situation of the individual patient. This is what can be done – obtaining a lengthening and an improvement in the quality of life – in patients with metastatic colorectal cancer by associating an antibody with chemotherapy administered intermittently, that is, only if and when it is necessary. It is the new ‘prescription’ as it emerges from Improve, an all-Italian study, coordinated by the Cancer Institute of Naples, and presented today in Chicago at Asco, the American Congress of Oncology.
20 months of progression-free survival
Colorectal cancers are in third place for frequency, with almost 50,000 new cases per year in Italy. The new treatment administration strategy would have had positive effects on 137 patients with metastatic colorectal cancer, in the first line of treatment, enrolled in 14 Italian centers. Initial data showed that administering the anti-EGFR antibody panitumumab with standard chemotherapy and comparing the classical mode of continuous administration versus alternating administration with interruption periods, in these patients the efficacy of the treatment was improved and at the same time the some side effects are mitigated, such as skin toxicity, which significantly impacts their quality of life. The study demonstrated for the first time in colorectal cancer that intermittent experimental treatment results in improved progression-free survival. In particular, progression-free survival in metastatic colon cancers reached 20 months with an improvement of 7 months compared to standard treatment.
Effects on the quality of life
All this means: fewer side effects, fewer visits to the hospital, better quality of life, disease-free survival which extends to 20 months compared to 13 months of standard treatment because, when the treatment is stopped, the cancer cells do not they have time to adapt to the drug and, therefore, develop resistance later on. “These results are of particular importance in clinical practice – he declares Antonio Avallonefirst signing of the Improve study, director of the Pascale Abdomen Experimental Clinical Oncology – responding to a deeply felt need of patients for a better quality of life and of particular relevance in the era of the Covid-19 pandemic as the treatment strategy intermittent reduces hospital admissions for patients “.
Biomarkers to personalize therapies
For which types of patients is this new therapeutic approach suitable? The answer comes from Alfredo Budillondirector of the Pascale Experimental Oncological Pharmacology Unit, co-principal investigator of the study and head of the associated translational studies: “The ongoing analyzes on the biological samples of the patients treated, also initiated in collaboration with the Federico II University of Naples, will allow to define biomarkers capable of optimizing and personalizing this new therapeutic strategy and at the same time verifying the biological rationale of the study based on the modulation of tumor evolution to counteract the emergence of resistance to treatment “.