ASCO, ITT, KRAS-WT primary OS results: CALGB failed to meet its primary endpoint of OS Cetuximab is not superior to Avastin in 1L KRAS-WT. CALGB/SWOG Phase III trial of FOLFIRI or mFOLFOX6 with bevacizumab or cetuximab for patients with expanded RAS analyses in. CALGB/SWOG Phase III trial of irinotecan/5-FU/leucovorin (FOLFIRI) or oxaliplatin/5-FU/leucovorin (mFOLFOX6) with bevacizumab (BV) or cetuximab.
|Published (Last):||23 April 2014|
|PDF File Size:||9.51 Mb|
|ePub File Size:||19.20 Mb|
|Price:||Free* [*Free Regsitration Required]|
This study has several limitations. Among patients who received cetuximab, patients with left-sided tumors lived 36 months, whereas those with right-sided tumors lived The median overall survival was For the primary analysis, researchers identified data from patients with right-sided primary tumors and patients with left-sided primary tumors.
No adjustments were made for multiple comparisons in the analysis of secondary end points. Patients were stratified for statistical analysis by the time of enrollment either before or 84005 the KRAS amendment. Patients were 18 years or older with an Eastern Cooperative Oncology Group performance status of 0 to 1 and normal hepatic, renal, and hematologic laboratory values. Secondary end points included response rate site-reported confirmed or unconfirmed complete or partial response by RECIST 84005 Evaluation Criteria in Solid Tumors] and progression-free survival measured from study entry until first documented progression or death.
Tick marks on the curves denote the last known follow-up time for patients with no death date reported. Hazard ratio estimates were adjusted for prior adjuvant therapy, prior radiotherapy, protocol chemotherapy, and randomization before and after the study was amended. This randomized clinical trial compares the effects of fruquintinib, a vascular endothelial growth calggb receptor VEGFR inhibitor, vs placebo on overall survival among patients with metastatic colorectal cancer whose disease progressed on treatment or who could not tolerate standard treatment because of toxic effects.
It is also an important reminder, in this exciting era of precision medicine, that genomics is not the only source of insight 800405 how cancers should be studied and calgn. Power was approximately 0. The data show that patients whose primary tumors originate on the left side of the colon the descending colon, sigmoid colon, and rectum survive significantly longer than those whose tumors originate on the right side the cecum and ascending colon. Dr Mulkerin reports receiving 804005 research grant support from the NCI cooperative group funding.
N Engl J Med.
Cetuximab, a chimerized monoclonal antibody to the epidermal growth factor receptor EGFRwas approved in combination with irinotecan or alone following irinotecan failure for patients with advanced 08405 metastatic colorectal cancer whose tumors expressed EGFR.
Conflict of Interest Disclosures: Sign in to customize your interests Sign in to your personal account. This analysis included only patients without a mutated KRAS gene, which is a known biomarker of response to certain colorectal cancer therapies cetuximab is approved only for treating KRAS wild-type tumors.
Continuation of bevacizumab after first progression in metastatic colorectal caalgb ML Cetuximab or bevacizumab was administered prior to cytotoxic chemotherapies: Ninety-six percent of of randomized patients with confirmed KRAS wt tumors started protocol therapy; 15 patients 1. Sign in to make a comment Sign in to your personal account. In Septemberthe combined treatment group of both cetuximab and bevacizumab with chemotherapeutic regimen was discontinued.
New guidelines to evaluate response to treatment in solid tumors. Dr Meyerhardt reports receiving personal fees from Genentech.
The patients randomized after and the patients registered before the KRAS amendment was implemented comprise the final primary analysis cohort Figure 1. This is speculative, however, because the collection of subsequent treatment details across hundreds of sites in North America is extremely difficult and the details of calggb data would be open to questioning no matter the resources put into such an effort.
Disease assessment was done by the treating investigator and was not 84005. Among patients with KRAS wt untreated advanced or metastatic colorectal cancer, there was no significant difference in overall survival between the addition of cetuximab vs bevacizumab to chemotherapy as initial biologic treatment.
For a longer-form examination of these data, click here.
Patients without reported deaths were censored at their last known follow-up. A fixed-block size of 9 was used prior to the study amendment that stopped enrollment into the double-biologic group. After 10 years and additional amendments a revised 2-group trial cetuximab vs bevacizumab with chemotherapy regimens completed patient enrollment and follow-up see eTable 1 in Supplement 2. PubMed Google Scholar Crossref. Median overall survival was Sign in to access your subscriptions Sign in to your personal account.
Conversely, among patients with left-sided tumors, treatment with cetuximab was associated with longer overall survival than bevacizumab 36 vs Ccalgb quality was reviewed and audited by the Alliance Statistics and Data Center and by the study chairperson following Alliance policies.
Analyses are based on clinical data and patient follow-up as of December 15, The Kaplan-Meier method was used to estimate overall and progression-free survival.
Data for patient covariates were captured in the NCI-standardized format and entered at calgv time of patient registration usually by a clinical research associate at the treating institution.
Unplanned subgroup analyses were conducted for the expanded RASsex, race, and chemotherapy subsets. Key Points Those with left-sided tumors had longer median overall survival However, overall survival favored cetuximab by 3. Within 3 years, 8405 lack of efficacy of EGFR antibodies in KRAS -mutant tumors 11 and failures of the dual antibody and chemotherapy combination treatments 1213 resulted in a pivotal amendment restricting eligibility to patients with confirmed KRAS wt tumors and then later to closure of the dual antibody group.
Based on these factors, patients and primary outcome events were needed.