Efficacy of panitumumab vs cetuximab in patients with wild-type KRAS exon 2 metastatic colorectal cancer treated with prior bevacizumab: Results from ASPECCT.

Authors

null

Marc Peeters

Antwerp University Hospital, Edegem, Belgium

Marc Peeters , Tae Won Kim , Jin Li , Stefano Cascinu , Paul Ruff , Attili Venkatasatya Suresh , Anne Thomas , Sergei Tjulandin , Xuesong Guan , Timothy Jay Price

Organizations

Antwerp University Hospital, Edegem, Belgium, Asan Medical Center, University of Ulsan, Seoul, Korea, The Republic of, Fudan University Cancer Hospital, Shanghai, China, Universita Politecnica delle Marche, Ancona, Italy, University of Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa, Apollo Hospital, Hyderabad, India, Leicester Royal Infirmary, Leicester, United Kingdom, N. N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia, Amgen Inc., Thousand Oaks, CA, The Queen Elizabeth Hospital, University of Adelaide, Adelaide, Australia

Research Funding

Pharmaceutical/Biotech Company

Background: The phase 3 ASPECCT trial in patients (pts) with chemorefractory wild type (WT) KRAS exon 2 metastatic colorectal cancer (mCRC) demonstrated that panitumumab (pmab) was noninferior to cetuximab (cmab) for overall survival (OS). A previous subgroup analysis of hazard ratios (HRs) suggested that pts who had received prior bevacizumab (bev; any line, at any point before study start) in the pmab arm may have had better outcomes vs pts in the cmab arm (Price et al. Lancet Oncol 2014;15:569). Methods: Pts were randomized 1:1 to receive pmab or cmab. The subset of pts who had received prior bev were analyzed based on the final analysis of ASPECCT. Results: 999 pts were randomized and treated: 499 pmab and 500 cmab. The prior bev subset included 126 pts in the pmab arm (25%) and 132 pts in the cmab arm (26%). Pts in the pmab arm had longer median OS and progression-free survival (PFS) and higher objective response rates (ORR) compared with pts in the cmab arm. Results are shown (table). After adjustment for baseline covariates including ECOGperformance status, number of metastatic sites, and baseline lactate dehydrogenase (LDH), OS hazard ratio (HR) was 0.65 (95%CI=0.49-0.85) with pmab vs cmab in pts who had received prior bev. Pts in the pmab and cmab arms who did not receive prior bev had similar OS, PFS, and ORR. Post-progression antitumor therapy was similar between the pmab (47%) and cmab arms (52%) in pts who received prior bev. Conclusions: In ASPECCT, pts with WT KRAS exon 2 mCRC who received prior bev-containing regimens may have derived greater benefit with pmab versus cmab monotherapy. Clinical trial information: NCT01001377

Prior Bev Treatment
No Prior Bev Treatment
Pmab
(N = 126)
Cmab
(N = 132)
Pmab
(N = 373)
Cmab
(N = 368)
OS, events (%)108 (85.7)122 (92.4)338 (90.6)334 (90.8)
Median (95% CI), mos11.3 (9.3–14.2)9.8 (8.3–11.7)10.0 (9.1–11.2)9.9 (9.0–11.1)
Hazard ratio (95% CI)0.73 (0.56–0.96)1.02 (0.87–1.19)
PFS, events (%)124 (98.4)130 (98.5)362 (97.1)360 (97.8)
Median (95% CI), mos4.7 (3.2–4.9)3.2 (3.0-4.8)3.8 (3.2–4.8)4.7 (3.3–4.8)
Hazard ratio (95% CI)0.84 (0.66–1.08)1.03 (0.89–1.19)
ORR, % (95% CI)*22.3 (15.3–30.8)15.0 (9.3–22.4)21.9 (17.8–26.5)21.5 (17.4–26.1)

*Evaluable pts.

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Abstract Details

Meeting

2016 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gastrointestinal (Colorectal) Cancer

Track

Gastrointestinal Cancer—Colorectal and Anal

Sub Track

Colorectal Cancer–Advanced Disease

Clinical Trial Registration Number

NCT01001377

Citation

J Clin Oncol 34, 2016 (suppl; abstr 3538)

DOI

10.1200/JCO.2016.34.15_suppl.3538

Abstract #

3538

Poster Bd #

235

Abstract Disclosures