Study On Clinical Application Of Cetuximab In EGFR Mutation Positive Bile Duct Carcinoma

Background and purposeThe incidence of biliary tract cancer increases year by year and ranks fifth in the digestive system tumor in China. Since the early symptoms of BTC are not typical,the most patients are diagnosed at the advanced stage.Surgery is still the first choice for treatment of biliary tract cancer. The treatment method of the advanced case is mainly for the radiotherapy and chemotherapy, but the effect is poor.Targeted therapeutics seek to block the signaling networks that promote tumor survival,growth and invasion. Cetuximab is a monoclonal antibody that selectively block the extracellular ligand-binding domain of the receptor, thereby preventing its activation. At present, cetuximab is mainly used for the patients with metastatic colorectal cancer. There is no domestic reports of cetuximab applied to EGFR mutation positive biliary tract cancer. The purpose of this study is to research on the effectiveness of cetuximab combination chemotherapy for patients with EGFR mutation positive biliary tract cancer. MethodsGemcitabine plus oxaliplatin and capecitabine regimen combined with cetuximab(experimental group) and Gemcitabine plus oxaliplatin and capecitabine regimen(control group) in the treatment of EGFR mutation positive patients with biliary tract cancer in 81 cases. ResultThe clinical benefit rate of the experimental group was 66.7%, and the clinical effective rate was 28.6%. The clinical benefit rate of control group was 35%, and the clinical effective rate was 13.3%. The clinical benefit rate of the two groups was compared, and the difference was statistically significant(c2=6.357,P=0.012). But there was no statistical significance in the clinical efficiency(c2=2.526,P=0.112). The 2 year survival rate of the experimental group was 48%, and median survival time was 21 months. The 2 year survival rate of the control group was 23%, and the median survival time was 14 months. The 2 year survival rate difference was statistically significant(c2=5.153,P=0.022).The incidence of experimental group between control group in the main adverse reaction rate was reseptively: skin toxicity(42.9%VS8.3%,c2=12.9,P=0), liver function damage(9.5%VS68.3%,c2=1.418,P=0.234), diarrhea(38.1%VS13.3%,c2=6.017,P=0.014), the myelosuppression of II0-IV0(38.1%VS16.7%,c2=4.133,P=0.042). ConclusionCetuximab combined with chemotherapy can significantly improve clinical benefit rate in patients with EGFR mutation positive biliary tract cancer,but there is no significant improvement in clinical efficiency, and adverse reaction rate is relatively light high.