Prognostic Value of EGFR Expression for Patients With Stage III Colorectal Cancer Receiving Fluoropyrimidine Metronomic Maintenance Therapy After Radical Resection and Adjuvant Oxaliplatin-Based Chemotherapy
Ching-Wen Huang*, Cheng-Jen Ma*†, Wei-Chih Su*, Yi-Ting Chen‡§, Hsiang-Lin Tsai*¶, Yung-Sung Yeh*#,
Tsung-Kun Chang*, Wen-Hung Hsu**††, Fang-Jung Yu**††, Jaw-Yuan Wang*¶‡‡§§¶¶##
* Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital,
Kaohsiung Medical University, Kaohsiung, Taiwan
† Division of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital,
Kaohsiung Medical University, Kaohsiung, Taiwan
‡ Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
§ Department of Pathology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
¶ Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
# Division of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital,
Kaohsiung Medical University, Kaohsiung, Taiwan
** Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital,
Kaohsiung Medical University, Kaohsiung, Taiwan
†† Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
‡‡ Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
§§ Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
¶¶ Clinical Pharmacogenomics and Pharmacoproteinomics, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
## Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
Oncology Research 2020, 28(7-8), 701-714. https://doi.org/10.3727/096504020X15986099915822
Abstract
This study evaluated the survival effects of metronomic maintenance therapy with oral fluoropyrimidine in
patients with stage III colorectal cancer (CRC) according to epidermal growth factor receptor (EGFR) expression.
We enrolled 197 patients with stage III CRC who had undergone radical resection and FOLFOX regimen adjuvant
chemotherapy. The clinicopathological features and effects of metronomic maintenance therapy with oral capecitabine (daily dose of 850 mg/m2
, twice daily, on days 1–14 every 3 weeks for 6 months) on survival according to
treatment group and EGFR expression were analyzed. By conducting an in vitro cell line study and in vivo study
through knockout of the EGFR gene, we analyzed the capacities of cell proliferation and migration. Relapse and
survival were significantly more common in the FOLFOX group. Metronomic maintenance therapy was a significantly independent associated factor of relapse and survival as well as a prognostic factor of disease-free survival
and overall survival. Significant intergroup differences in survival were only observed in patients with positive
EGFR expression. Thus, our findings suggest EGFR expression is a prognostic factor in patients with stage III
CRC receiving metronomic maintenance therapy. Analysis of EGFR expression in these patients helps identify
potential candidates who may receive the optimal survival benefit from metronomic maintenance therapy.
Keywords
Cite This Article
Huang, C., Ma, C., Su, W., Chen, Y., Tsai, H. et al. (2020). Prognostic Value of EGFR Expression for Patients With Stage III Colorectal Cancer Receiving Fluoropyrimidine Metronomic Maintenance Therapy After Radical Resection and Adjuvant Oxaliplatin-Based Chemotherapy.
Oncology Research, 28(7-8), 701–714. https://doi.org/10.3727/096504020X15986099915822