FOLFOXIRI Plus Panitumumab in First-Line Treatment of Colorectal Cancer
Posted: Wednesday, December 11, 2019
Based on the randomized phase II VOLFI study, Dominik P. Modest, MD, of the German Cancer Consortium, Heidelberg, Germany, and colleagues have shown that adding the monoclonal antibody panitumumab to the modified FOLFOXIRI regimen improved the objective response rate and the rate of secondary resection of metastases in patients with RAS wild-type colorectal cancer. According to the study authors, this combination therapy may represent an option for selected and fit patients in the first-line setting.
“Future studies should determine whether the addition of panitumumab to modified FOLFOXIRI prolongs survival,” proposed the investigators in the Journal of Clinical Oncology.
A total of 96 patients with RAS wild-type colorectal cancer were evaluated in this report. A total of 64 patients in the experimental arm were given FOLFOXIRI (leucovorin, fluorouracil, irinotecan, oxaliplatin) plus panitumumab. A total of 33 patients in the control arm received FOLFOXIRI alone. The median follow-up in the experimental and control arms was 44.2 months and 63.3 months, respectively.
The objective response rate was reported to be 87.3% in the experimental arm, compared with 60.6% in the control arm (P = .004). In addition, the addition of panitumumab improved the secondary resection rate (33.3% vs. 12.1%; P = .02). The progression-free survival rate was similar in both arms, although the rate of overall survival favored FOLFOXIRI plus panitumumab (hazard ratio = 0.67). The authors noted that further studies are needed to determine whether the addition of panitumumab to chemotherapy will prolong survival in this patient population.
In terms of side effects, a higher rate of grade 3 to 4 toxicity was observed in the panitumumab-based study arm than in the control arm (81.3% vs. 66.7%). However, the rate of grade 3 to 4 neutropenia was higher with FOLFOXIRI alone than with the addition of panitumumab (21.2% vs. 15.6%).
Disclosure: The study authors’ disclosure information can be found at ascopubs.org.