Dai Inoue, Satoshi Matsusaka, Noiriko Yamamoto, Mitsukuni Suenaga, Eiji Shinozaki, Nobuyuki Mizunuma, Yuichi Ishikawa and Kiyohiko Hatake
Background: There are few evidence which kind of tumor is more benefit from cetuximab, more investigations of supplementary predictive factors are highly relevant. The purpose is to evaluate the prognostic significance of CD133 expression and to investigate the utility as biomarker of prognosis of metastatic colorectal cancer (mCRC) patients treated with cetuximab. Methods: We investigated progression-free survival (PFS) and overall survival (OS) of patients with mCRC about 5FU-based regimen as first line chemotherapy and cetuximab as salvage line retrospectively, and performed immunohistochemical staining to evaluate the CD133 status. Non-parametric statistics, univariate and multivariate analysis were used. Results: From October 2008 to June 2009, 46 patients with measurable mCRC had received cetuximab as salvage line, and all of them had treated with 5FU-based regimen as first line. In first line chemotherapy, the median OS was 33.1 months (95% CI, 25.6-40.4) in the CD133-positive patients as compared with 16.0 months (95% CI, 0.938-31.1) in the CD133-negative patients (P=0.004), but there were no statistically significant difference in PFS between both group. In salvage therapy with cetuximab, the median OS was 8.8 months (95% CI, 5.24-12.4) in the CD133-positive patients as compared with 5.1 months (95% CI, 3.23-6.90) in the CD133-negative patients (P=0.007). The median PFS was also significantly better in CD133-positive patients, with a median of 5.2 month (95% CI, 2.96-7.51) in the CD133-positive patients as compared with 2.8 month (95% CI, 1.48-4.06) in CD133- negative patients (P=0.046). Univariate and multivariate Cox proportional hazards regression was performed, and it is shown that CD133 predicted OS and PFS of cetuximab. Conclusions: CD133 status was correlated with the prognosis of patients
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