Cetuximab/irinotecan/5-FU +/-oxaliplatin or FOLFOXIRI +/- bevacizumab in patients with colorectal cancer and nonresectable liver metastases (AIO CELIM2-study).

Authors

null

Gunnar Folprecht

University Hospital Carl Gustav Carus, Dresden, Germany

Gunnar Folprecht , Marika Mende , Torsten Liersch , Wolf Otto Bechstein , Claus-Henning Kohne , Alexander Stein , Volker Kunzmann , Michael Ghadimi , Ulf Peter Neumann , Sven Nilsson , Alexander Koenig , Ursula Pession , Achim Troja , Manfred Glados , Mathias Kleiss , Ulrike Ubbelohde , Juergen Weitz

Organizations

University Hospital Carl Gustav Carus, Dresden, Germany, University Hospital Goettingen, Goettingen, Germany, Department of General and Visceral Surgery, University Hospital Frankfurt, Frankfurt, Germany, Klinikum Oldenburg, Oldenburg, Germany, HOPE–Practice for Oncology, Hamburg, Germany, Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II and Comprehensive Cancer Center Mainfranken, Würzburg, Germany, Department of General and Visceral Surgery, University Medical Center Goettingen, Goettingen, Germany, University Hospital RWTH Aachen, Aachen, Germany, University Hospital Hamburg Eppendorf, Hamburg, Germany, Department of Gastroenterology and Gastrointestinal Oncology, University Medical Center Goettingen, Göttingen, Germany, Universitätsklinikum Oldenburg, Oldenburg, Germany, Gemeinschaftspraxis Dr. Glados & Partner, Coesfeld, Germany, Department of Interdisciplinary Oncology, Red Cross Hospital, Kassel, Germany, University Hospital Carl Gustav Carus, University Cancer Center/Surgical Department, Dresden, Germany

Research Funding

Pharmaceutical/Biotech Company
Merck-Serono

Background: EGFR based combinations and the triplet combination FOLFOXIRI are known to increase response rates compared to doublet combinations. Methods: Patients with colorectal cancer and non-resectable liver metastases were enrolled into the trial. RAS wild type patients were randomised to cetuximab/FOLFIRI or cetuximab/FOLFOXIRI, RAS/BRAF mutant patients were randomised to FOLFOXIRI with or without bevacizumab. The primary endpoint was response. Secondary endpoints included progression free and overall survival. The trial was closed early due to poor recruitment. Results: Between 2014 and 2018, ninety-two pts were enrolled into the study. 54 wild type pts were randomised into cetuximab based treatment with (28 pts) or without (26 pts) oxaliplatin, 38 RAS/BRAF mutant pts were randomised to receive FOLFOXIRI alone (18 pts) or plus bevacizumab (16 pts). Objective response was achieved in 21/26 pts (81 % [95 CI: 61 – 93 %]) with cet/FOLFIRI, 24/28 pts (86 % [95 CI: 67 – 96 %]) with cet / FOLFOXIRI, 13/1 8 pts (72 % [95 CI: 46 – 90 %]) with FOLFOXIRI and 14/20 pts (70 % [95 CI: 46 – 88 %]) with bev/FOLFOXIRI. Two pts with cet/FOLFOXIRI and one pat with FOLFOXIRI achieved CR according to imaging. The median PFS was 12.7 [95 % CI: 7.2 – 18.2], 15.0 [95 % CI: 11.3 – 18.7], 17.5 [95 % CI: 8.0 – 27.1] and 15.0 [95 % CI: 11.4 – 18.5] months with cet/FOLFIRI, cet/FOLFOXIRI, FOLFOXIRI and bev/FOLFOXIRI. The median overall survival was 42 mo. [95 % CI: 28 – 55], 55 [95 % CI:41 – 68], 28 [95 % CI: 22 – 36] and 44 [95 % CI: 0 – 94] months with cet/FOLFIRI, cet/FOLFOXIRI, FOLFOXIRI and bev/FOLFOXIRI. The frequency of grade ≥ 3 toxicity per arm (cet/FOLFIRI, cet/FOLFOXIRI, FOLFOXIRI and bev/FOLFOXIRI) was 29 %, 46 %, 56 %. 45 % for neutropenia/leukopenia, 11 %, 12 %, 28 %, 25 % for diarrhea and 29 %, 19 %, 6 % and 5 % for skin toxicities. Conclusions: High response rates were observed in patients with colorectal liver metastases with all regimens. The numerically highest response rate was observed in RAS wild type patients treated with cetuximab/FOLFOXIRI. Clinical trial information: NCT01802645.

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Session

Session Title

Gastrointestinal Cancer—Colorectal and Anal

Track

Gastrointestinal Cancer—Colorectal and Anal

Sub Track

Colorectal Cancer–Advanced Disease

Clinical Trial Registration Number

NCT01802645

Citation

J Clin Oncol 38: 2020 (suppl; abstr 4024)

DOI

10.1200/JCO.2020.38.15_suppl.4024

Abstract #

4024

Poster Bd #

16

Abstract Disclosures