XELIRI-bevacizumab versus FOLFIRI-bevacizumab as first-line treatment in patients with metastatic colorectal cancer: a Hellenic Cooperative Oncology Group phase III trial with collateral biomarker analysis

XELIRI-贝伐单抗与 FOLFIRI-贝伐单抗作为转移性结直肠癌患者的一线治疗:一项希腊肿瘤合作组 III 期临床试验及其附带生物标志物分析

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作者:Dimitrios Pectasides, George Papaxoinis, Konstantine T Kalogeras, Anastasia G Eleftheraki, Ioannis Xanthakis, Thomas Makatsoris, Epaminondas Samantas, Ioannis Varthalitis, Pavlos Papakostas, Nikitas Nikitas, Christos N Papandreou, George Pentheroudakis, Eleni Timotheadou, Angelos Koutras, Joseph Sgo

Background

The

Conclusions

This trial did not show significant differences in efficacy between the groups. However, the toxicity profile was different. Baseline plasma osteopontin concentrations demonstrated independent prognostic significance. ( Registration number: ACTRN12610000270011).

Methods

Patients previously untreated for metastatic disease were randomized in: group A (irinotecan, capecitabine, bevacizumab, every 3 weeks; XELIRI-bevacizumab) and group B (irinotecan, leucovorin, fluorouracil, bevacizumab, every 2 weeks; FOLFIRI-bevacizumab). Primary endpoint was progression-free survival (PFS). Plasma concentrations of nitric oxide, osteopontin, TGF-β1 and VEGF-A were measured at baseline and during treatment.

Results

Among 285 eligible patients, 143 were randomized to group A and 142 to group B. Fifty-five patients (38.5%) in group A and 57 (40.1%) in group B responded (p = 0.81). After a median follow-up of 42 months, median PFS was 10.2 and 10.8 months (p = 0.74), while median OS was 20.0 and 25.3 months (p = 0.099), for groups A and B, respectively. Most frequent grade 3-4 toxicities (group A vs group B) were neutropenia (13% vs 22%, p = 0.053) and diarrhea (19% vs 11%, p = 0.082). Baseline plasma osteopontin concentrations demonstrated prognostic significance for both PFS and OS. Conclusions: This trial did not show significant differences in efficacy between the groups. However, the toxicity profile was different. Baseline plasma osteopontin concentrations demonstrated independent prognostic significance. ( Registration number: ACTRN12610000270011).

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