Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2024; 12(18): 3360-3367
Published online Jun 26, 2024. doi: 10.12998/wjcc.v12.i18.3360
Effect of cetuximab plus FOLFOX4 regimen on clinical outcomes in advanced gastric carcinoma patients receiving evidence-based care
Hui Ying, Ren-Jun Huang, Xiao-Min Jing, Yan Li, Qun-Qiu Tong
Hui Ying, Ren-Jun Huang, Department of General Surgery, Yongkang First People's Hospital, Yongkang 321300, Zhejiang Province, China
Xiao-Min Jing, Yan Li, Qun-Qiu Tong, Department of Oncology, Yongkang First People's Hospital, Yongkang 321300, Zhejiang Province, China
Co-first authors: Hui Ying and Xiao-Min Jing.
Author contributions: Ying H, Jing XM and Huang RJ designed the research and wrote the first manuscript; Ying H, Jing XM, Li Y, Tong QQ and Huang RJ contributed to conceiving the research and analyzing data; Ying H, Jing XM and Huang RJ conducted the analysis and provided guidance for the research; All authors reviewed and approved the final manuscript. Both Ying H and Jing XM have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-first authors. Ying H applied for and obtained the funds for this research project. Ying H conceptualized, designed, and supervised the whole process of the project. Ying H searched the literature, revised and submitted the early version of the manuscript. Jing XM was instrumental and responsible for data re-analysis and re-interpretation, figure plotting, comprehensive literature search, preparation and submission of the current version of the manuscript. This collaboration between Ying H and Jing XM is crucial for the publication of this manuscript and other manuscripts still in preparation.
Institutional review board statement: This study was approved by the Ethic Committee of Yongkang First People's Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ren-Jun Huang, Doctor, Associate Chief Physician, Department of General Surgery, Yongkang First People's Hospital, No. 599 Jinshan West Road, Yongkang 321300, Zhejiang Province, China. 13758992301@163.com
Received: February 28, 2024
Revised: April 23, 2024
Accepted: May 10, 2024
Published online: June 26, 2024
Processing time: 110 Days and 22.7 Hours
Abstract
BACKGROUND

Although chemotherapy is effective for treating advanced gastric carcinoma (aGC), it may lead to an adverse prognosis. Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for improving efficacy and outcomes in aGC patients.

AIM

To determine the efficacy and safety of cetuximab (CET) combined with the FOLFOX4 regimen (infusional fluorouracil, folinic acid, and oxaliplatin) as first-line therapy for patients with aGC, who received evidence-based care (EBC).

METHODS

A total of 117 aGC patients who received EBC from March 2019 to March 2022 were enrolled. Of these, 60 in the research group (RG) received CET + FOLFOX4 as first-line therapy, whereas 57 in the control group (CG) received FOLFOX4. The efficacy [clinical response rate (RR) and disease control rate (DCR)], safety (liver and kidney dysfunction, leukopenia, thrombocytopenia, rash, and diarrhea), serum tumor marker expression [STMs; carbohydrate antigen (CA) 19-9, CA72-4, and carcinoembryonic antigen (CEA)], inflammatory indicators [interleukin (IL)-2 and IL-10], and quality of life (QOL) of the two groups were compared.

RESULTS

A markedly higher RR and DCR were observed in the RG compared with the CG, with an equivalent safety profile between the two groups. RG exhibited notably reduced CA19-9, CA72-4, CEA, and IL-2 levels following treatment, which were lower than the pre-treatment levels and those in the CG. Post-treatment IL-10 was statistically increased in RG, higher than the pre-treatment level and the CG. Moreover, a significantly improved QOL was evident in the RG.

CONCLUSION

The CET + FOLFOX4 regimen is highly effective as first-line treatment for aGC patients receiving EBC. It facilitates the suppression of STMs, ameliorates the serum inflammatory microenvironment, and enhances QOL, without increased adverse drug effects.

Keywords: Cetuximab, FOLFOX4 regimen, Evidence-based care, Advanced gastric carcinoma, Efficacy and safety

Core Tip: This study primarily analyzes the effect of cetuximab in combination with FOLFOX4 regimen (infusional fluorouracil, folinic acid, and oxaliplatin) as first-line therapy on the clinical outcomes of patients with advanced gastric carcinoma receiving evidence-based care. Based on the efficacy, serum tumor markers (STMs), inflammatory indicators, and improvement in quality of life (QOL), first-line treatment with cetuximab combined with the FOLFOX4 regimen has a profound effect on patients with advanced gastric carcinoma receiving evidence-based care, without increasing adverse drug effects, which is conducive to inhibiting STMs, ameliorating the serum inflammatory microenvironment, and enhancing patient QOL.