- No name references
Randomized Phase III Study of Panitumumab With FOLFIRI Compared With FOLFIRI Alone As Second-Line Treatment in Patients With mCRC
Investigated (inv)
Comparator (comp)
Primary
PANI+FOLFIRI
FOLFIRI
PFS KRAS WT
5.9 mo
3.9 mo
OS KRAS WT
14.5 mo
12.5 mo
Secondaries
PANI+FOLFIRI
FOLFIRI
PFS KRAS MT
5.0 mo
4.9 mo
OS KRAS MT
11.8 mo
11.1 mo
(all grades, %)
PANI+FOLFIRI
FOLFIRI
p
Skin toxicity (gr. 3-4)
37
2
NA
Neutropenia (gr. 3-4)
20
23
NA
Diarrhea (gr. 3-4)
14
9
NA
Mucositis (gr. 3-4)
8
3
NA
Hypokalemia (gr. 3-4)
7
1
NA
Pulmonary embolism (gr. 3-4)
5
2
NA
Dehydration (gr. 3-4)
3
2
NA
Hypomagnesemia (gr. 3-4)
3
<1
NA
Paronychia (gr. 3-4)
3
<1
NA
Febrile neutropenia (gr. 3-4)
2
3
NA
Infusion-related reaction gr. 3-4 (panitumumab)
<1
NA
NA
- ≥18 years old
- ECOG 0-2
- diagnosis of adenocarcinoma of the colon or rectum
- only one prior chemotherapy regimen for mCRC consisting of first-line fluoropyrimidine-based chemotherapy
- radiographically confirmed disease progression must have occurred during or within 6 months of prior first-line chemotherapy
- at least one unidimensionally measurable lesion (≥20 mm)
- a pretreatment paraffin-embedded tumor tissue from the primary tumor or metastasis had to be available for central analyses of EGFR and biomarker testing. Neither EGFR expression nor KRAS status was required for enrollment.
- had received prior irinotecan or prior anti-EGFR therapy
- systemic chemotherapy, hormonal therapy, immunotherapy, approved proteins/antibodies, or any experimental agent or therapy (within 30 days) or radiotherapy (within 14 days)
- must not have had major surgery 28 days before random assignment.
Characteristics
PANI+FOLFIRI
FOLFIRI
Agedc-comma sex & race (KRAS WT)
Age (range)dc-comma yr
60 (28-84)
61 (29-86)
Agedc-comma sex & race (KRAS MT)
Age (range)dc-comma yr
61 (29-83)
64 (29-86)
ECOG performance status
0-1 (KRAS WT)dc-comma %
95
93
2 (KRAS WT)dc-comma %
5
7
0-1 (KRAS WT)dc-comma %
94
94
2 (KRAS MT)dc-comma %
6
6
Primary tumor type
Colon (KRAS WT)dc-comma %
62
64
Rectal (KRAS WT)dc-comma %
38
36
Colon (KRAS MT)dc-comma %
66
66
Rectal (KRAS MT)dc-comma %
34
34
Sites of metastatic disease (KRAS WT)
Liver onlydc-comma %
17
20
Liver & otherdc-comma %
68
64
Other onlydc-comma %
16
15
Missing or unknowndc-comma %
0
<1
Sites of metastatic disease (KRAS MT)
Liver onlydc-comma %
16
14
Liver & otherdc-comma %
70
69
Other onlydc-comma %
14
16
Missing or unknowndc-comma %
<1
<1
Prior therapydc-comma %
Oxaliplatin (KRAS WT)
67
65
Bevacizumab (KRAS WT)
18
20
Oxaliplatin (KRAS MT)
69
68
Bevacizumab (KRAS MT)
19
17
—
—
—
—
—
—
—
Ad-hoc:
no.pts inv.
no.pts comp.
PANI+FOLFIRI
FOLFIRI
CR KRAS WT, %
—
—
0.0
0.0
CR KRAS MTdc-comma %
—
—
0.0
0.0
analisys of PFS KRAS WT
PANI+FOLFIRI
FOLFIRI
HR (95% CI)
Primary tumor type
colon (376)
—
—
0.77 (0.60-0.99)
rectal (221)
—
—
0.74 (0.53-1.03)
Liver mets
Yes (110)
—
—
0.53 (0.32-0.89)
No (487)
—
—
0.81 (0.65-1.01)
No. of mets sites
<3 (315)
—
—
0.68 (0.51-0.91)
≥3 (280)
—
—
0.84 (0.63-1.11)
ECOG
0 (304)
—
—
0.82 (0.61-1.10)
1 (257)
—
—
0.76 (0.56-1.03)
Age
< 65 yr (361)
—
—
0.69 (0.53-0.90)
≥ 65 yr (236)
—
—
0.87 (0.64-1.20)
Prior bevacizumab
Yes (115)
—
—
0.71 (0.45-1.13)
No (482)
—
—
0.77 (0.61-0.96)
Prior oxaliplatin
Yes (395)
—
—
0.68 (0.53-0.86)
No (202)
—
—
0.89 (0.61-1.31)
Sex
Male (379)
—
—
0.75 (0.58-0.96)
Female (218)
—
—
0.77 (0.55-1.08)
—
—
analisys of OS KRAS WT
PANI+FOLFIRI
FOLFIRI
HR (95% CI)
Primary tumor type
colon (376)
—
—
0.86 (0.68-1.10)
rectal (221)
—
—
0.89 (0.64-1.23)
Liver mets
Yes (110)
—
—
0.78 (0.48-1.26)
No (487)
—
—
0.87 (0.70-1.07)
No. of mets sites
<3 (315)
—
—
0.90 (0.68-1.20)
≥3 (280)
—
—
0.84 (0.64-1.10)
ECOG
0 (304)
—
—
0.82 (0.61-1.09)
1 (257)
—
—
0.96 (0.72-1.29)
Age
< 65 yr (361)
—
—
0.92 (0.71-1.18)
≥ 65 yr (236)
—
—
0.81 (0.60-1.09)
Prior bevacizumab
Yes (115)
—
—
0.68 (0.43-1.07)
No (482)
—
—
0.91 (0.74-1.13)
Prior oxaliplatin
Yes (395)
—
—
0.79 (0.63-0.99)
No (202)
—
—
1.00 (0.70-1.44)
Sex
Male (379)
—
—
0.83 (0.65-1.07)
Female (218)
—
—
0.92 (0.67-1.26)
—
—
- No name references
2007-05-02
RUTHANN M. GIUSTI
FDA Drug Approval Summary: Panitumumab
2007-05-01
Eric Van Cutsem
Open-Label Phase III Trial of Panitumumab Plus Best Supportive Care Compared With Best Supportive Care Alone in Patients With Chemotherapy-Refractory Metastatic Colorectal Cancer
Investigated (inv)
Comparator (comp)
(all grades, %)
PANI+BSC
BSC
p
Acneiform dermatitis
57
1
NA
Growth of eyelashes
6
0
NA
- all patients were required to have EGFR expression defined as at least 1 membrane staining in 1% of tumor cellsdc-return- had progressed on or following treatment with regimen(s) containing a fluoropyrimidine, oxaliplatin, and irinotecandc-return- had to have received at least two but no more than three prior chemotherapy regimens for metastatic colorectaldc-returncancerdc-return- had to have measurable disease
Characteristics
PANI+BSC
BSC
Age & sex
Maledc-comma n(%)
146 (63)
148 (64)
Median agedc-comma yr (range)
62.0 (27–83)
63.0 (27–82)
Primary site
Colondc-comma n(%)
153 (66)
157 (68)
Rectumdc-comma n(%)
78 (34)
75 (32)
ECOG PS scoredc-comma n(%)
Number of disease sitesdc-comma n(%)
Metastatic sitedc-comma n(%)
Lymph nodes
52 (23)
66 (28)
Months since metastatic diagnosis
Range
5.2 - 129.2
4.6 - 68.6
Prior metastatic regimensdc-comma n(%)
Cells with EGFR membrane staining
Intensity of EGFR staining
3dc-plusdc-comma strong
20%
18%
2dc-plusdc-comma moderate
53%
49%
1dc-plusdc-comma weak
26%
34%
—
—
—
—
—
Ad-hoc:
no.pts inv.
no.pts comp.
PANI+BSC
BSC
analisys of PFS
PANI+BSC
BSC
HR (95% CI)
Age
<65 yr
—
—
0.51 (0.40-0.67)
≥65 yr
—
—
0.60 (0.43-0.83)
Sex
Male
—
—
0.57 (0.44-0.73)
Female
—
—
0.51 (0.36-0.71)
Primary tumor
Colon
—
—
0.55 (0.43-0.70)
Rectal
—
—
0.53 (0.37-0.75)
ECOG PS
Prior regimens
Metastasis sites
Intensity of EGFR staining
2dc-plus
—
—
0.51 (0.39-0.67)
3dc-plus
—
—
0.58 (0.37-0.90)
Cells with EGFR membrane
1 - <10%
—
—
0.47 (0.31-0.71)
10 - 100%
—
—
0.57 (0.46-0.72)
—
—
analisys of —
PANI+BSC
BSC
HR (95% CI)
—
—
—
—
—
—
—
—
—
—
- No name references
2004-06-03
Herbert Hurwitz
Bevacizumab plus Irinotecan, Fluorouracil, and Leucovorin for Metastatic Colorectal Cancer
Investigated (inv)
Comparator (comp)
Secondaries
BEVA+IFL
PLB+IFL
(all grades, %)
BEVA+IFL
PLB+IFL
p
Leukopenia (gr.3-4)
37.0
31.1
NA
Diarrhea (gr.3-4)
32.4
24.7
NA
Hypertension
22.4
8.3
<0.01
Hypertension gr. 3
11.0
2.3
<0.01
Any thrombotic event
19.4
16.2
NA
Deep thrombophlebitis
8.9
6.3
NA
Pulmonary embolus
3.6
5.1
NA
Bleeding (gr.3-4)
3.1
2.5
NA
Proteinuria grade 3
0.8
0.8
NA
Gastrointestinal perforation
1.5
0.0
NA
Death within 60 days
3.0
4.9
NA
AE leading to hospitalization
44.9
39.6
NA
AE leading to discontinuation of treatment
8.4
7.1
NA
- histologically confirmed metastatic colorectal carcinoma, with bidimensionally measurable diseasedc-return- at least 18 years, an Eastern Cooperative Oncology Group (ECOG) performance status 8 of 0 or 1, a life expectancy of more than three months, and written informed consentdc-return- Adequate hematologic, hepatic, and renal function (including urinary excretion of no more than 500 mg of protein per day)
- prior chemotherapy or biologic therapy for metastatic disease (adjuvant or radiosensitizing use of fluoropyrimidines with or without leucovorin or levamisole more than 12 months before study entry was permitted)dc-return- receipt of radiotherapy within 14 days before the initiation of study treatmentdc-return- major surgery within 28 days before the initiation of study treatmentdc-return- clinically significant cardiovascular diseasedc-return- clinically detectable ascitesdc-return- pregnancy or lactationdc-return- regular use of aspirin (more than 325 mg per day) or other nonsteroidal antiinflammatory agents, preexisting bleeding diatheses or coagulopathy or the need for full-dose anticoagulationdc-return- known central nervous system metastases
Characteristics
BEVA+IFL
PLB+IFL
Sex and age
Mean agedc-comma yr
59.5
59.2
Racedc-comma %
Location of centerdc-comma %
Australia or New Zealand
<1
<1
ECOG performance statusdc-comma %
Type of cancerdc-comma %
Number of metastatic sitesdc-comma %
Prior cancer therapydc-comma %
Adjuvant chemotherapy
24
28
Median duration of metastatic disease
Median duration of metastatic diseasedc-comma mo
4
4
—
—
—
—
—
—
Ad-hoc:
no.pts inv.
no.pts comp.
BEVA+IFL
PLB+IFL
analisys of OS
BEVA+IFL
PLB+IFL
HR (95% CI)
—
—
—
—
—
—
—
—
—
—
analisys of —
BEVA+IFL
PLB+IFL
HR (95% CI)
—
—
—
—
—
—
—
—
—
—