RAISE: A randomized, double-blind, multicenter phase III study of irinotecan, folinic acid, and 5-fluorouracil (FOLFIRI) plus ramucirumab (RAM) or placebo (PBO) in patients (pts) with metastatic colorectal carcinoma (CRC) progressive during or following first-line combination therapy with bevacizumab (bev), oxaliplatin (ox), and a fluoropyrimidine (fp).

Authors

Josep Tabernero

Josep Tabernero

Vall d'Hebron University Hospital, Barcelona, Spain

Josep Tabernero , Allen Lee Cohn , Radka Obermannova , Gyorgy Bodoky , Rocio Garcia-Carbonero , Tudor-Eliade Ciuleanu , David Craig Portnoy , Eric Van Cutsem , Axel Grothey , Jana Prausová , Pilar Garcia-Alfonso , Kentaro Yamazaki , Philip R. Clingan , Vittorina Zagonel , Tae Won Kim , Lorinda Simms , Shao-Chun Chang , Federico Nasroulah , Takayuki Yoshino

Organizations

Vall d'Hebron University Hospital, Barcelona, Spain, Rocky Mountain Cancer Centers, US Oncology, Denver, CO, Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic, Szent László Hospital, Budapest, Hungary, Hospital Virgen del Rocio, Sevilla, Spain, Prof. Dr. I. Chiricuta Institute of Oncology, Cluj County, Romania, The West Clinic, Memphis, TN, University Hospitals Gasthuisberg/Leuven, Leuven, Belgium, Mayo Clinic, Rochester, MN, Rochester, MN, University Hospital Motol, Prague, Czech Republic, Hospital General Universitario Gregorio Marañón, Madrid, Spain, Shizuoka Cancer Center, Shizuoka, Japan, Southern Medical Day Care Centre, Wollongong, Australia, Oncologia Medica I, Istituto Oncologico Veneto, IRCCS, Padova, Italy, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea, Eli Lilly Canada Inc., Toronto, ON, Canada, Eli Lilly and Company, Indianapolis, IN, Eli Lilly and Company, Bridgewater, NJ, National Cancer Center Hospital East, Kashiwa, Japan

Research Funding

Pharmaceutical/Biotech Company

Background: Angiogenesis is an important therapeutic target in CRC; VEGF plays a key role in angiogenesis. RAM is a human IgG1 monoclonal antibody that targets the extracellular domain of VEGFR-2. The RAISE study evaluated the efficacy and safety of adding RAM to standard second-line treatment FOLFIRI. Methods: Eligible pts with mCRC who progressed on or after first-line combination therapy with bev, ox, and fp, had an ECOG PS of 0 or 1, and adequate organ function were randomized 1:1 (stratified by region, KRAS mutation status, and time to progressive disease [PD] after beginning first-line treatment) to receive RAM (8 mg/kg IV) plus FOLFIRI or PBO plus FOLFIRI every 2 weeks until PD, unacceptable toxicity, or death. The primary endpoint was overall survival (OS). Secondary endpoints included progression-free survival (PFS), objective response rate (ORR), and safety. Planned sample size of 1,050 pts ensured 85% power to demonstrate statistical significance at an overall two-sided alpha of 0.05, assuming a hazard ratio (HR) of 0.8. Results: Between Dec 2010 and Aug 2013, 1,072 eligible pts were randomized (RAM 536; PBO 536). Baseline pt characteristics were similar between treatment arms. The OS HR was 0.84 (95% CI: 0.73, 0.98; log-rank p=0.0219). Median OS was 13.3months (m) for RAM vs 11.7m for PBO. The PFS HR was 0.79 (95% CI: 0.70, 0.90; log-rank p = 0.0005). Median PFS with RAM was 5.7m and 4.5m for PBO. ORR was 13.4% RAM; 12.5% PBO (p = 0.6336). Subgroup results were consistent with the OS and PFS results. Grade ≥3 adverse events (AEs) occurring in >5% of pts in RAM+FOLFIRI were: neutropenia (RAM 38.4% vs PBO 23.3% ), hypertension (11.2% vs 2.8%), diarrhea (10.8% vs 9.7%), and fatigue (11.5% vs 7.8%). Conclusions: RAISE met its primary end-point, demonstrating a statistically significant improvement in OS for RAM and FOLFIRI vs PBO and FOLFIRI in second-line mCRC pts. Benefits were similar across important clinical subgroups and no unexpected AEs were identified. Clinical trial information: NCT01183780

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Abstract Details

Meeting

2015 Gastrointestinal Cancers Symposium

Session Type

Oral Abstract Session

Session Title

Oral Abstract Session: Cancers of the Colon, Rectum, and Anus

Track

Cancers of the Colon, Rectum, and Anus

Sub Track

Multidisciplinary Treatment

Clinical Trial Registration Number

NCT01183780

Citation

J Clin Oncol 33, 2015 (suppl 3; abstr 512)

DOI

10.1200/jco.2015.33.3_suppl.512

Abstract #

512

Abstract Disclosures