Complicated Puzzle in Cetuximab-Based Chemotherapy: Skin Toxicity and Resection Rate in Patients With Initially Unresectable Colorectal Liver Metastases

摘要

To the Editor: We read the excellent article written by Ye et al in Journal of Clinical Oncology. It was reported that the addition of cetuximab to fluorouracil, leucovorin, and irinotecan or modified fiuorouracil, leucovorin, and oxaliplatin was associated with facilitated radical resections of liver metastases, providing improved long-term survival in patients with initially unresectable colorectal liver metastases (wild-type KRAS). The authors are to be congratulated on successfully indicating that cetuximab combined with chemotherapy improved the resectability of liver metastases and prolonged survival compared with chemotherapy alone. However, we question whether the cetuximab-induced skin toxicity was associated with R0 resection rates for liver metastases. In Table 3 of their article,1 based on subgroup analysis, patients with grade 2 to 3 acne-like rash experienced no significant benefit compared with those with grade 0 to 1 acne-like rash in terms of progression-free survival (PFS) and overall survival (OS), although the authors mentioned that patients with grade 2 to 3 skin reactions experienced greater benefit than those with grade 0 to 1 skin reactions in terms of response rate and OS, without statistical significance.