Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Oct 22;10(10):e0140717.
doi: 10.1371/journal.pone.0140717. eCollection 2015.

Panitumumab Use in Metastatic Colorectal Cancer and Patterns of KRAS Testing: Results from a Europe-Wide Physician Survey and Medical Records Review

Jörg Trojan  1 , Laurent Mineur  2 , Jiří Tomášek  3 , Etienne Rouleau  4 , Pavel Fabian  3 , Giovanna de Maglio  5 , Pilar García-Alfonso  6 , Giuseppe Aprile  5 , Aliki Taylor  7 , George Kafatos  7 , Gerald Downey  7 , Jan-Henrik Terwey  8 , J Han van Krieken  9
Affiliations

Panitumumab Use in Metastatic Colorectal Cancer and Patterns of KRAS Testing: Results from a Europe-Wide Physician Survey and Medical Records Review

Jörg Trojan et al. PLoS One. .

Abstract

Background: From 2008-2013, the European indication for panitumumab required that patients' tumor KRAS exon 2 mutation status was known prior to starting treatment. To evaluate physician awareness of panitumumab prescribing information and how physicians prescribe panitumumab in patients with metastatic colorectal cancer (mCRC), two European multi-country, cross-sectional, observational studies were initiated in 2012: a physician survey and a medical records review. The first two out of three planned rounds for each study are reported.

Methods: The primary objective in the physician survey was to estimate the prevalence of KRAS testing, and in the medical records review, it was to evaluate the effect of test results on patterns of panitumumab use. The medical records review study also included a pathologists' survey.

Results: In the physician survey, nearly all oncologists (299/301) were aware of the correct panitumumab indication and the need to test patients' tumor KRAS status before treatment with panitumumab. Nearly all oncologists (283/301) had in the past 6 months of clinical practice administered panitumumab correctly to mCRC patients with wild-type KRAS status. In the medical records review, 97.5% of participating oncologists (77/79) conducted a KRAS test for all of their patients prior to prescribing panitumumab. Four patients (1.3%) did not have tumor KRAS mutation status tested prior to starting panitumumab treatment. Approximately one-quarter of patients (85/306) were treated with panitumumab and concurrent oxaliplatin-containing chemotherapy; of these, 83/85 had confirmed wild-type KRAS status prior to starting panitumumab treatment. All 56 referred laboratories that participated used a Conformité Européenne-marked or otherwise validated KRAS detection method, and nearly all (55/56) participated in a quality assurance scheme.

Conclusions: There was a high level of knowledge amongst oncologists around panitumumab prescribing information and the need to test and confirm patients' tumors as being wild-type KRAS prior to treatment with panitumumab, with or without concurrent oxaliplatin-containing therapy.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: JTr has acted in an advisory role and in speakers’ bureaus for Amgen Ltd., Merck Serono, F. Hoffmann-La Roche, Bayer and Sanofi. LM has acted in an advisory role and speaker's bureau for Amgen Ltd., Merck Serono, Sanofi, F. Hoffman-La Roche, Baxter and Fresenius. JTo has acted in an advisory role and in speakers’ bureaus for Amgen Ltd., Merck Serono, F. Hoffmann-La Roche and Bayer. ER has acted in an advisory role for AstraZeneca and Glaxo Wellcome, received a grant as a speaker for AstraZeneca, and has received research funding from F. Hoffmann-La Roche and Amgen Ltd. PF has participated in advisory boards for Amgen and Pfizer and has received honoraria as a speaker for Amgen Ltd., Merck Serono, Astra Zeneca, F. Hoffmann-La Roche and Pfizer. GdM has no relevant disclosures. PG-A has acted in an advisory role and in speakers’ bureaus for Amgen Ltd., Merck Serono, F. Hoffmann-La Roche, Bayer and Sanofi, and has also received research funding from F. Hoffmann-La Roche and Bayer. GA has acted as a speaker for Amgen Ltd., Merck Serono, F. Hoffmann-La Roche, Sanofi, and Lilly. AT is a compensated employee of Amgen Ltd. as an Observational Research Medical Director and a stockholder in Amgen Ltd. GK is a compensated employee of Amgen Ltd. as an Observational Research Senior Manager and a stockholder in Amgen Ltd. GD is a compensated employee of Amgen Ltd. as a Biostatistics Senior Manager and a stockholder in Amgen Ltd. J-HT is a compensated employee of Amgen Ltd. as the Medical Director of Switzerland and a stockholder in Amgen Ltd. JHvK has participated in advisory boards for Amgen Ltd., Merck Serono, GlaxoSmithKline, and Sakura, and has received honoraria and research grants from these companies. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Physician disposition for the A) physician survey and B) medical records review studies.
See this image and copyright information in PMC

References

    1. Bokemeyer C, Bondarenko I, Makhson A, Hartmann JT, Aparicio J, et al. (2009) Fluorouracil, leucovorin, and oxaliplatin with and without cetuximab in the first-line treatment of metastatic colorectal cancer. J Clin Oncol 27: 663–671. 10.1200/JCO.2008.20.8397 - DOI - PubMed
    1. Cunningham D, Humblet Y, Siena S, Khayat D, Bleiberg H, et al. (2004) Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. N Engl J Med 351: 337–345. - PubMed
    1. Jonker DJ, O'Callaghan CJ, Karapetis CS, Zalcberg JR, Tu D, et al. (2007) Cetuximab for the treatment of colorectal cancer. N Engl J Med 357: 2040–2048. - PubMed
    1. Sobrero AF, Maurel J, Fehrenbacher L, Scheithauer W, Abubakr YA, et al. (2008) EPIC: phase III trial of cetuximab plus irinotecan after fluoropyrimidine and oxaliplatin failure in patients with metastatic colorectal cancer. J Clin Oncol 26: 2311–2319. 10.1200/JCO.2007.13.1193 - DOI - PubMed
    1. Van Cutsem E, Köhne CH, Hitre E, Zaluski J, Chang Chien CR, et al. (2009) Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med 360: 1408–1417. 10.1056/NEJMoa0805019 - DOI - PubMed

Publication types