Efficacy of FOLFIRI plus cetuximab vs FOLFIRI plus bevacizumab in 1st-line treatment of older patients with RAS wild-type metastatic colorectal cancer: an analysis of the randomised trial FIRE-3

Medientyp: E-Artikel
Titel: Efficacy of FOLFIRI plus cetuximab vs FOLFIRI plus bevacizumab in 1st-line treatment of older patients with RAS wild-type metastatic colorectal cancer: an analysis of the randomised trial FIRE-3
Beteiligte: Fischer, Laura E.; Stintzing, Sebastian; von Weikersthal, Ludwig Fischer; Modest, Dominik P.; Decker, Thomas; Kiani, Alexander; Kaiser, Florian; Al-Batran, Salah-Eddin; Heintges, Tobias; Lerchenmüller, Christian; Kahl, Christoph; Seipelt, Gernot; Kullmann, Frank; Stauch, Martina; Scheithauer, Werner; Giessen-Jung, Clemens; Uhlig, Jens; Peuser, Bettina; Denzlinger, Claudio; Stahler, Arndt; Weiss, Lena; Heinrich, Kathrin; Held, Swantje; Jung, Andreas; [...]
Erschienen: Springer Science and Business Media LLC, 2022
Erschienen in: British Journal of Cancer
Sprache: Englisch
DOI: 10.1038/s41416-022-01854-y
ISSN: 0007-0920; 1532-1827
Schlagwörter: Cancer Research ; Oncology
Entstehung:
Anmerkungen:
Beschreibung: <jats:title>Summary</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>The evidence on the efficacy of anticancer therapy is limited in older patients with metastatic colorectal cancer (mCRC). This retrospective analysis of phase III FIRE-3 trial assesses the efficacy of FOLFIRI plus either cetuximab or bevacizumab according to the patients’ age and sidedness of primary tumour.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>The study endpoints overall response rate (ORR), progression-free survival (PFS) and overall survival (OS) were compared between younger (<65 years) and older (≥65 years) patients, followed by stratification according to primary tumour sidedness. ORR was compared using Fisher´s exact test, OS and PFS were estimated by the Kaplan–Meier method and compared using the log-rank test. Univariate Cox regression analyses assessed hazard ratios and 95% confidence intervals for OS and PFS.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Overall, older patients with <jats:italic>RAS</jats:italic> WT tumours had a significantly shorter OS when compared to younger patients (25.9 months vs 29.3 months, HR 1.29; <jats:italic>P</jats:italic> = 0.02). Also the proportion of right-sided tumours was significantly greater in older patients (27.1% vs 17.9%; <jats:italic>P</jats:italic> = 0.029). Secondary resection rates were numerically higher in younger patients (25.4% vs. 17.6%, <jats:italic>P</jats:italic> = 0.068) than in older patients. This was primarily seen in the Cetuximab arm, where older patients underwent less likely resection (13.1% vs. 26%; <jats:italic>P</jats:italic> = 0.02). Older patients with left-sided tumours showed only a trend towards greater efficacy of cetuximab (HR 0.86; <jats:italic>P</jats:italic> = 0.38). In patients with right-sided primary tumours, older patients did not appear to benefit from cetuximab in contrast to younger patients (≥65 years: 16.6 months vs 23.6 months, HR 1.1; <jats:italic>P</jats:italic> = 0.87; <65 years: 21.9 months vs 16.4 months HR 1.5; <jats:italic>P</jats:italic> = 0.31).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>In FIRE-3, OS was generally shorter in older patients in comparison to younger patients. This could be explained by the overrepresentation of right-sided tumours and a lower secondary resection rate in older patients. The efficacy of targeted therapy was dependent on tumour sidedness in older patients with <jats:italic>RAS</jats:italic> WT mCRC.</jats:p> </jats:sec><jats:sec> <jats:title>Clinical trial</jats:title> <jats:p>FIRE-3 (NCT00433927).</jats:p> </jats:sec>
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