TY - JOUR
T1 - SPIRITT
T2 - A randomized, multicenter, phase II study of panitumumab with FOLFIRI and bevacizumab with FOLFIRI as second-line treatment in patients with unresectable wild type KRAS metastatic colorectal cancer
AU - Hecht, J. Randolph
AU - Cohn, Allen
AU - Dakhil, Shaker
AU - Saleh, Mansoor
AU - Piperdi, Bilal
AU - Cline-Burkhardt, Mika
AU - Tian, Ying
AU - Go, William Y.
N1 - Funding Information:
Research support for the study was provided by Amgen Inc. Employees of Amgen Inc were involved in the study design, and in the collection, analysis, and interpretation of the data. Shawn Lee ( Amgen Inc) and James Ziobro (funded by Amgen Inc) provided medical writing support for this report. The decision to submit the article for publication was made by all authors.
Funding Information:
J. Randolph Hecht has received honoraria from Amgen, Inc, and his institution has received research funding from Amgen, Inc. Allen Cohn has received honoraria from Amgen, Inc. Mansoor Saleh has received research funding from Amgen, Inc. Bilal Piperdi is a compensated consultant and advisor and has received honoraria from Amgen, Inc. Ying Tian is a compensated employee and stockholder of Amgen, Inc. William Y. Go was a compensated employee and stockholder of Amgen, Inc. The remaining authors have stated that they have no conflicts of interest.
Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Background Second-line treatment with chemotherapy and anti-epidermal growth factor receptor or anti-vascular endothelial growth factor antibodies improves outcomes in patients with wild type Kirsten rat sarcoma viral oncogene homolog (KRAS) metastatic colorectal cancer (mCRC). The choice of biological agent in second-line mCRC remains unclear. In this randomized, phase II estimation trial, we compared FOLFIRI (irinotecan, 5-fluorouracil, and leucovorin) in combination with panitumumab or bevacizumab in patients with disease progression during oxaliplatin-based chemotherapy and bevacizumab. Patients and Methods One hundred eighty-two patients were randomized to FOLFIRI with panitumumab or bevacizumab. The primary end point was progression-free survival (PFS). Secondary end points included overall survival (OS), objective response rate (ORR), and safety. Results PFS was similar between arms, with a hazard ratio (HR) of 1.01 (95% confidence interval [CI], 0.68-1.50; P =.97). Median PFS was 7.7 months (95% CI, 5.7-11.8) in the panitumumab arm and 9.2 months (95% CI, 7.8-10.6) in the bevacizumab arm. OS was also similar between arms, with an HR of 1.06 (95% CI, 0.75-1.49; P =.75). Median OS was 18.0 months (95% CI, 13.5-21.7) in the panitumumab arm and 21.4 months (95% CI, 16.5-24.6) in the bevacizumab arm. ORR was 32% (95% CI, 23%-43%) in the panitumumab arm and 19% (95% CI, 11%-29%) in the bevacizumab arm. Skin disorders, diarrhea, hypomagnesemia, hypokalemia, dehydration, and hypotension were more frequent in the panitumumab arm. Neutropenia was more frequent in the bevacizumab-containing arm. Conclusion Panitumumab or bevacizumab with FOLFIRI as second-line treatment had efficacy similar in patients whose disease progressed during oxaliplatin-based chemotherapy with bevacizumab, with expected toxicities. The development of more accurate biomarkers might help caregivers and patients to better choose between therapies for individual patients.
AB - Background Second-line treatment with chemotherapy and anti-epidermal growth factor receptor or anti-vascular endothelial growth factor antibodies improves outcomes in patients with wild type Kirsten rat sarcoma viral oncogene homolog (KRAS) metastatic colorectal cancer (mCRC). The choice of biological agent in second-line mCRC remains unclear. In this randomized, phase II estimation trial, we compared FOLFIRI (irinotecan, 5-fluorouracil, and leucovorin) in combination with panitumumab or bevacizumab in patients with disease progression during oxaliplatin-based chemotherapy and bevacizumab. Patients and Methods One hundred eighty-two patients were randomized to FOLFIRI with panitumumab or bevacizumab. The primary end point was progression-free survival (PFS). Secondary end points included overall survival (OS), objective response rate (ORR), and safety. Results PFS was similar between arms, with a hazard ratio (HR) of 1.01 (95% confidence interval [CI], 0.68-1.50; P =.97). Median PFS was 7.7 months (95% CI, 5.7-11.8) in the panitumumab arm and 9.2 months (95% CI, 7.8-10.6) in the bevacizumab arm. OS was also similar between arms, with an HR of 1.06 (95% CI, 0.75-1.49; P =.75). Median OS was 18.0 months (95% CI, 13.5-21.7) in the panitumumab arm and 21.4 months (95% CI, 16.5-24.6) in the bevacizumab arm. ORR was 32% (95% CI, 23%-43%) in the panitumumab arm and 19% (95% CI, 11%-29%) in the bevacizumab arm. Skin disorders, diarrhea, hypomagnesemia, hypokalemia, dehydration, and hypotension were more frequent in the panitumumab arm. Neutropenia was more frequent in the bevacizumab-containing arm. Conclusion Panitumumab or bevacizumab with FOLFIRI as second-line treatment had efficacy similar in patients whose disease progressed during oxaliplatin-based chemotherapy with bevacizumab, with expected toxicities. The development of more accurate biomarkers might help caregivers and patients to better choose between therapies for individual patients.
KW - EGFR
KW - VEGF
KW - WT
KW - metastatic colorectal cancer
UR - http://www.scopus.com/inward/record.url?scp=84929331013&partnerID=8YFLogxK
U2 - 10.1016/j.clcc.2014.12.009
DO - 10.1016/j.clcc.2014.12.009
M3 - Article
C2 - 25982297
AN - SCOPUS:84929331013
SN - 1533-0028
VL - 14
SP - 72
EP - 80
JO - Clinical Colorectal Cancer
JF - Clinical Colorectal Cancer
IS - 2
ER -
