Final results and OS of the randomized phase II VOLFI trial (AIO- KRK0109): mFOLFOXIRI + panitumumab versus FOLFOXIRI as first-line treatment in patients with RAS wild- type metastatic colorectal cancer (mCRC).

Authors

null

Michael Geissler

Klinikum Esslingen, Department of Internal Medicine, Oncology/Hematology, Gastroenterology, Esslingen, Germany

Michael Geissler , Jorge Riera-Knorrenschild , Uwe Marc Martens , Swantje Held , Jobst Greeve , Axel Florschütz , Thomas Jens Ettrich , Stephan Kanzler , Andrea Tannapfel , Volker Heinemann , Anke C. Reinacher-Schick , Thomas Seufferlein , Dominik Paul Modest , Swen Wessendorf

Organizations

Klinikum Esslingen, Department of Internal Medicine, Oncology/Hematology, Gastroenterology, Esslingen, Germany, Universitatsklinikum, Giessen Und Marburg, Germany, SLK-Kliniken Heilbronn, Klinik für Innere Medizin, Heilbronn, Germany, ClinAssess GmbH, Leverkusen, Germany, St. Vincenz-Krankenhaus Paderborn, Paderborn, Germany, Stadtisches Klinikum Dessau, Dessau, Germany, Ulm University Hospital, Ulm, Germany, Leopoldina Krankenhaus, Schweinfurt, Germany, Ruhr-University Bochum, Department of Pathology, Bochum, Germany, University Hospital Munich, LMU Munich, Munich, Germany, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany, Department of Medicine I, Hospital of the University Ulm, Ulm, Germany, Department of Medicine III, University Hospital, LMU Munich, Munich, Germany, Klinikum Esslingen Hematology/Oncology, Esslingen, Germany

Research Funding

Other
Pharmaceutical/Biotech Company

Background: This trial evaluated activity and safety of mFOLFOXIRI + panitumumab vs FOLFOXIRI in ECOG 0-1, primarily non-resectable mCRC patients. The final primary endpoint was presented at ASCO and ESMO 2018. Now we report for the first time the final results regarding OS and PFS. Methods: Prospective 2:1 randomized, controlled, open label multi-center, phase II trial comparing mFOLFOXIRI (Ox 85 mg/m2, Iri 150 mg/m2, 5-FU 3000mg/m2 cont. 48h, LV 200 mg/m2) + Panitumumab 6 mg/KG (arm A) with FOLFOXIRI (Ox 85 mg/m2, Iri 165 mg/m2, 5-FU 3200mg/m2 cont. 48h, LV 200 mg/m2; arm B), both arms q2w. Prospective strata were cohort 1: irresectable mCRC (n=65), and cohort 2: chance of secondary resection of metastatic lesions (n=31). Primary endpoint was ORR, secondary endpoints were secondary resection rate (cohort 2), DCR, PFS, OS, toxicity, quality of life (QLQ-C30). Financially supported by an unrestricted grant from Amgen. Results: A total of 96 patients were randomized (63 arm A, 33 arm B). ORR was 87.3% in arm A and 60.6% in arm B (p=0.0041, OR 4.47; 95%-CI 1.614-12.376). Secondary resections of metastases in the ITT population were observed in 33·3% (arm A Pmab) versus 12·1% (arm B) (OR=3.63; 95%-CI 1.13–11.67, p=0·029) and in cohort 2 in 75% (arm A Pmab) versus 36.4% (arm B) (OR=5.25; 95%-CI 1.07–25.8, p=0.05), respectively. Median PFS was similar in the study arms (9.7 mo in both arms, HR 1.071; 95%-CI 0.689-1.665, p=0.76). OS in the ITT population showed a strong trend in favour of the Pmab-containing arm A with a median OS of 35.7 mo compared to 29.8 mo in arm B (HR: 0·67; 95%-CI 0.41-1.11, P=0·12). mOS of cohort 2 was 52.0 mo in arm A versus 41.7 mo in arm B (HR 0.413; 95%-CI 0.15-1.12, p=0.07). Further results regarding to sidedness and BRAF mutational status will be presented. Conclusions: The addition of Pmab to a mFOLFOXIRI regimen in patients with RASwildtype metastatic colorectal cancer significantly improved objective response rate and the rate of secondary resection of metastases. Although PFS was comparable, there was a strong trend towards improved OS in the Pmab arm. Future studies are warranted to confirm this trend towards improved overall survival with this regimen. Clinical trial information: NCT01328171

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Gastrointestinal (Colorectal) Cancer

Track

Gastrointestinal Cancer—Colorectal and Anal

Sub Track

Colorectal Cancer–Advanced Disease

Clinical Trial Registration Number

NCT01328171

Citation

J Clin Oncol 37, 2019 (suppl; abstr 3511)

DOI

10.1200/JCO.2019.37.15_suppl.3511

Abstract #

3511

Poster Bd #

3

Abstract Disclosures