Cited by 850Colorectal Cancer Treatments and StudiesColorectal Cancer Surgical TreatmentsPancreatic and Hepatic Oncology Research

A randomized phase IIIB trial of chemotherapy, bevacizumab, and panitumumab compared with chemotherapy and bevacizumab alone for metastatic colorectal cancer

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Hecht, J. Randolph, Mitchell, Edith, Chidiac, Tarek, Scroggin, Carroll, Hagenstad, Christopher, Spigel, David, Marshall, John, Cohn, Allen +5 more·2009·Journal of Clinical Oncology

Abstract

Purpose: Panitumumab, a fully human antibody targeting the epidermal growth factor receptor, is active in patients with metastatic colorectal cancer (mCRC). This trial evaluated panitumumab added to bevacizumab and chemotherapy (oxaliplatin- and irinotecan-based) as first-line treatment for mCRC. Patients and Methods: Patients were randomly assigned within each chemotherapy cohort to bevacizumab and chemotherapy with or without panitumumab 6 mg/kg every 2 weeks. The primary end point was progression-free survival (PFS) within the oxaliplatin cohort. Tumor assessments were performed every 12 weeks and reviewed centrally. Results: A total of 823 and 230 patients were randomly assigned to the oxaliplatin and irinotecan cohorts, respectively. Panitumumab was discontinued after a planned interim analysis of 812 oxaliplatin patients showed worse efficacy in the panitumumab arm. In the final analysis, median PFS was 10.0 and 11.4 months for the panitumumab and control arms, respectively (HR, 1.27; 95% CI, 1.06 to 1.52); median survival was 19.4 months and 24.5 months for the panitumumab and control arms, respectively. Grade 3/4 adverse events in the oxaliplatin cohort (panitumumab v control) included skin toxicity (36% v 1%), diarrhea (24% v 13%), infections (19% v 10%), and pulmonary embolism (6% v 4%). Increased toxicity without evidence of improved efficacy was observed in the panitumumab arm of the irinotecan cohort. KRAS analyses showed adverse outcomes for the panitumumab arm in both wild-type and mutant groups. Conclusion: The addition of panitumumab to bevacizumab and oxaliplatin- or irinotecan-based chemotherapy results in increased toxicity and decreased PFS. These combinations are not recommended for the treatment of mCRC in clinical practice.

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Authors
Hecht, J. R., Mitchell, E., Chidiac, T., Scroggin, C., Hagenstad, C., Spigel, D., Marshall, J., Cohn, A., McCollum, D., Stella, P., Deeter, R., Shahin, S., & Amado, R. G.
Affiliations
Amgen (United States) (US)
Venue
Journal of Clinical Oncology
Published
2009-02-10
Volume
27
Issue
5
Pages
672-680
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
OpenAlex
W2002226820
Cited by
850
References
30
Citations by year
2026: 5 · 2025: 8 · 2024: 19 · 2023: 10 · 2022: 21 · 2021: 15 · 2020: 29 · 2019: 29 · 2018: 26 · 2017: 38 · 2016: 44 · 2015: 57 · 2014: 56 · 2013: 88 · 2012: 101
FWCI
53.42
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Oncology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Amgen
Topics
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Surgical Treatments
  • Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
Keywords
metastatic colorectal cancer, panitumumab, bevacizumab, oxaliplatin, irinotecan, EGFR inhibition, first-line chemotherapy, progression-free survival, treatment toxicity, KRAS mutation, anti-EGFR monoclonal antibody
MeSH terms
Bevacizumab, Irinotecan, Oxaliplatin, Panitumumab, Adult, Aged, Aged, 80 and over, Antibodies, Monoclonal, Antineoplastic Agents, Antineoplastic Combined Chemotherapy Protocols, Camptothecin, Female, Humans, Male, Middle Aged, Neoplasm Metastasis, Organoplatinum Compounds, Colorectal Neoplasms, Antibodies, Monoclonal, Humanized

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