Early magnesium reduction in advanced colorectal cancer patients treated with cetuximab plus irinotecan as predictive factor of efficacy and outcome

Antonio Russo, Fabio Fulfaro, Bruno Beomonte Zobel, Marianna Silletta, Giordano Dicuonzo, Laura Rocci, Sara Galluzzo, Fabrizio Battistoni, Bruno Vincenzi, Vincenzo Adamo, Giuseppe Tonini, Daniele Santini

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43 Citazioni (Scopus)

Abstract

Introduction: Magnesium plays a role in a large number of cellular metabolic reactions.Cetuximab is able to induce hypomagnesemia by interfering with magnesium (Mg2+) transportin the kidney.We designed this trial to investigate if Mg2+ serum level modifications may be relatedwith clinical response andoutcome in advancedcolorectal cancer patients during treatment withcetuximab plus irinotecan.Experimental Design: Sixty-eight heavily pretreatedmetastatic colorectal cancer patients wereevaluatedfor Mg2+ serum levels at the following time points: before; 6 hours; and1, 7, 14, 21, 50,and92 days after the start of treatment.Results: Basal Mg2+ median levels were significantly decreased just 7 days after the firstanticancer infusion and progressively decreased from the 7th day onward, reaching the highestsignificance at the last time point (P < 0.0001).Twenty-five patients showeda reduction in medianMg2+ circulating levels of at least 20% within the 3rdweek after the first infusion. Patients withthis reduction showed a response rate of 64.0% versus 25.6% in the nonreduced Mg2+ group.The median time to progression was 6.0 versus 3.6 months in the reduced Mg2+ group andin thatwithout reduction, respectively (P < 0.0001). Overall survival was longer in patients with Mg2+reduction than in those without (10.7 versus 8.9 months).Conclusions: Our results confirm that cetuximab treatment may induce a reduction of Mg2+circulating levels andoffer the first evidence that Mg2+ reduction may represent a new predictivefactor of efficacy in advanced colorectal cancer patients treated with cetuximab plus irinotecan
Lingua originaleEnglish
pagine (da-a)4219-4224
Numero di pagine6
RivistaClinical Cancer Research
Volume14
Stato di pubblicazionePublished - 2008

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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    Russo, A., Fulfaro, F., Zobel, B. B., Silletta, M., Dicuonzo, G., Rocci, L., Galluzzo, S., Battistoni, F., Vincenzi, B., Adamo, V., Tonini, G., & Santini, D. (2008). Early magnesium reduction in advanced colorectal cancer patients treated with cetuximab plus irinotecan as predictive factor of efficacy and outcome. Clinical Cancer Research, 14, 4219-4224.