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.

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The primary end point was overall survival. Hazard ratio and P value for the RAS analysis are adjusted for prior adjuvant therapy, prior radiotherapy, protocol chemotherapy, and randomization before or after the amendment restricting eligibility to KRAS wild type tumor KRAS is defined as exon 2 codons 12, 13; exon 4, codons; exon 3 codons 59, 61 or NRAS: James Cancer Hospital, Columbus. In Septemberthe combined treatment group of both cetuximab and bevacizumab with chemotherapeutic regimen was discontinued.

Therapeutic anticoagulation was permitted as long as the patient was therapeutic on a stable dose of anticoagulant. At randomization, the primary physician indicated whether the treatment goal was palliative or potentially curative. Sign in to make a comment 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 calgn only for treating KRAS wild-type tumors.

This also contributed to the survival results.

Because treatment holidays were used more commonly during the course of calyb study and because collection of the details of treatment drugs and schedules, dosing and complications has been challenging, it is difficult to infer the effects of subsequent management decisions. Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search alerts.


In this patient population, those with left-sided tumors had longer median overall survival The consensus molecular subtypes of colorectal cancer. Patients with a significant bleeding event within 6 months of enrollment or a gastrointestinal perforation within 12 months of enrollment were excluded unless the capgb bowel segment had been resected. The chemotherapy by biologic interaction HR for overall survival was 1.

The primary statistical analyses were 2-sided tests of superiority comparing cetuximab vs bevacizumab with regard to the primary and main secondary outcomes among patients whose tumors were determined to be KRAS wt exon 2, codons 12,13 by Southwest Oncology Group review using intention-to-treat analyses.

As of December 15,median follow-up for surviving patients was 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.

The median overall survival was See treatment administration and dose modification summary for details eTable 2 in Supplement 2.

Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. In addition, some patients may have benefitted from subsequent experimental or off-label treatments. An additional secondary end point was day mortality assessed as the proportion of patients dying due to any cause within 60 days of beginning protocol therapy.

Thus, these analyses should be considered exploratory. Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account.

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Dr Mulkerin reports receiving institutional research grant support from the NCI cooperative group funding. Power was approximately 0.

The median progression-free survival was Patients enrolled and consented to the companion study whose tumor was KRAS wt and who received single antibody treatment were included in the primary cohort. Response rates were not significantly different, The trial was designed to target a hazard ratio HR of 0. Response rates were not significantly different, The majority of patients also had access to both cetuximab and bevacizumab at progression because each biologic therapy was commercially available.


The primary end point of overall survival was defined as time of study entry until death.

Third, one element not included in the on-study information was primary cancer site eg, right vs left colon. Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: Get free access to newly published articles Create a personal account or sign in to: A randomized phase IIIB trial of chemotherapy, bevacizumab, and panitumumab compared with chemotherapy and bevacizumab alone for metastatic colorectal cancer.

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Individual patient data analysis of progression-free survival versus overall survival 8040 a first-line end point for metastatic colorectal cancer in modern randomized trials: Patient and tumor characteristics are presented in Table 1. Dr Meyerhardt reports receiving personal fees from Genentech.

Initially, enrolled patients could consent to the biomarker companion study Cancer and Leukemia Group B and submit a specimen for EGFR status evaluation. No significant differences were observed for either overall survival or progression-free survival in the primary analysis cohort.

The results for overall survival HR, 0.