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A phase 3 trial evaluating panitumumab plus best supportive care vs best supportive care in chemorefractory wild-type KRAS or RAS metastatic colorectal cancer.


ABSTRACT: We assessed the treatment effect of panitumumab plus best supportive care (BSC) vs BSC on overall survival (OS) in patients with chemorefractory wild-type KRAS exon 2 metastatic colorectal cancer (mCRC) and report the first prospective extended RAS analysis in a phase 3 trial.Patients with wild-type KRAS exon 2 mCRC were randomised 1?:?1 to panitumumab (6?mg?kg-1 Q2W) plus BSC or BSC. On-study crossover was prohibited. RAS mutation status was determined by central laboratory testing. The primary endpoint was OS in wild-type KRAS exon 2 mCRC; OS in wild-type RAS mCRC (KRAS and NRAS exons 2, 3, and 4) was a secondary endpoint.Three hundred seventy seven patients with wild-type KRAS exon 2 mCRC were randomised. Median OS was 10.0 months with panitumumab plus BSC vs 7.4 months with BSC (HR=0.73; 95% CI=0.57-0.93; P=0.0096). RAS ascertainment was 86%. In wild-type RAS mCRC, median OS for panitumumab plus BSC was 10.0 vs 6.9 months for BSC (HR=0.70; 95% CI=0.53-0.93; P=0.0135). Patients with RAS mutations did not benefit from panitumumab (OS HR=0.99; 95% CI=0.49-2.00). No new safety signals were observed.Panitumumab significantly improved OS in wild-type KRAS exon 2 mCRC. The effect was more pronounced in wild-type RAS mCRC, validating previous retrospective analyses.

SUBMITTER: Kim TW 

PROVIDER: S-EPMC5104888 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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A phase 3 trial evaluating panitumumab plus best supportive care vs best supportive care in chemorefractory wild-type KRAS or RAS metastatic colorectal cancer.

Kim Tae Won TW   Elme Anneli A   Kusic Zvonko Z   Park Joon Oh JO   Udrea Anghel Adrian AA   Kim Sun Young SY   Ahn Joong Bae JB   Valencia Ricardo Villalobos RV   Krishnan Srinivasan S   Bilic Ante A   Manojlovic Nebojsa N   Dong Jun J   Guan Xuesong X   Lofton-Day Catherine C   Jung A Scott AS   Vrdoljak Eduard E  

British journal of cancer 20161013 10


<h4>Background</h4>We assessed the treatment effect of panitumumab plus best supportive care (BSC) vs BSC on overall survival (OS) in patients with chemorefractory wild-type KRAS exon 2 metastatic colorectal cancer (mCRC) and report the first prospective extended RAS analysis in a phase 3 trial.<h4>Methods</h4>Patients with wild-type KRAS exon 2 mCRC were randomised 1 : 1 to panitumumab (6 mg kg<sup>-1</sup> Q2W) plus BSC or BSC. On-study crossover was prohibited. RAS mutation status was determi  ...[more]

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