Efficacy of Panitumumab and Cetuximab in Patients with Colorectal Cancer Previously Treated with Bevacizumab; a Combined Analysis of Individual Patient Data from ASPECCT and WJOG6510G

Cancers - Tập 12 Số 7 - Trang 1715
Hiroya Taniguchi1,2, Takeharu Yamanaka3, Daisuke Sakai4, Kei Muro1, Kentaro Yamazaki5, Susumu Nakata6, Hiroyuki Kimura7, Paul Ruff8, Tae Won Kim9, Marc Peeters10, Timothy Price11
1Department of Clinical Oncology, Aichi Cancer Centre, Nagoya 464-8681, Japan
2Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Centre Hospital East, Kashiwa 277-8577, Japan
3Department of Biostatistics, Yokohama City University School of Medicine, Yokohama 236-0004, Japan
4Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita 565-0871, Japan
5Division of Gastrointestinal Oncology, Shizuoka Cancer Centre, Shizuoka 411-8777, Japan
6Department of Clinical Oncology, Kyoto Pharmaceutical University, Kyoto 607-8414, Japan
7Department of Analytical and Bioinorganic Chemistry, Kyoto Pharmaceutical University, Kyoto 607-8414, Japan
8University of Witwatersrand MRC Common Epithelial Cancers Research Centre, Johannesburg 2193, South Africa
9Department of Oncology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul 05505, Korea
10Department of Oncology, U.Z.A. University Hospital Antwerp, 2650 Edegem, Belgium
11Department of Medical Oncology, Queen Elizabeth Hospital and University of Adelaide, 5011 Woodville, Australia

Tóm tắt

Background: Phase-III ASPECCT and randomised phase-II WJOG6510G trials demonstrated the noninferiority of panitumumab, when compared with cetuximab, for overall survival in patients with chemotherapy-refractory wild-type KRAS exon 2 metastatic colorectal cancer. Methods: The subgroup that received bevacizumab either prior to panitumumab or cetuximab monotherapy (ASPECCT) or in combination with irinotecan (WJOG6510G) was included. Multivariate Cox models were created, including the treatment arms as covariates together with patient, disease and treatment characteristics. Results: We included 185 and 189 patients in the panitumumab and cetuximab arms, respectively. The median overall survival was 12.8 and 10.1 months [p = 0.0031; log-rank test, stratified by trial; hazard ratio (HR), 0.72; 95% confidence interval (CI), 0.58–0.90], and the median progression-free survival was 4.7 and 4.1 months, in the panitumumab and cetuximab arms, respectively (p = 0.0207; HR, 0.79; 95% CI, 0.64–0.97). The treatment regimen was an independent prognostic factor of overall survival (adjusted HR, 0.69; 95% CI, 0.54–0.87; p = 0.0013). Conclusions: Panitumumab significantly prolonged the overall survival and progression-free survival, when compared with cetuximab in the cohort that previously received bevacizumab in the included studies. Clinical Trial Registration: ASPECCT trial registered with ClinicalTrials.gov (NCT01001377) and WJOG6510G trial registered with UMIN-CTR (UMIN000006643).

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