Depth of response of induction therapy and consecutive maintenance treatment in patients with RAS wild-type metastatic colorectal cancer: An analysis of the PanaMa trial (AIO KRK 0212)

Sommerhauser, Greta; Kurreck, Annika; Beck, Alexander; Fehrenbach, Uli; Karthaus, Meinolf; Fruehauf, Stefan; Graeven, Ullrich; Mueller, Lothar; Koenig, Alexander O.; Weikersthal, Ludwig F. v.; Goekkurt, Eray; Haas, Siegfried; Stahler, Arndt; Heinemann, Volker; Held, Swantje; Alig, Annabel H. S.; Kasper, Stefan; Stintzing, Sebastian; Trarbach, Tanja und Modest, Dominik P. (2022): Depth of response of induction therapy and consecutive maintenance treatment in patients with RAS wild-type metastatic colorectal cancer: An analysis of the PanaMa trial (AIO KRK 0212). In: European Journal of Cancer, Bd. 178: S. 37-48

Abstract

Background: In patients with RAS wild-type metastatic colorectal cancer, depth of response (DpR) has gained importance as a novel end-point in clinical trials. We investigated the overall DpR, as well as the prognostic and predictive impact of DpR to induction therapy (six cycles of 5-fluorouracil, leucovorin [FU/FA], oxaliplatin [FOLFOX] and panitumumab [Pmab]) on consecutive maintenance therapy (FU/FA plus Pmab or FU/FA alone) in patients treated within the PanaMa trial.Methods: Central radiological assessment was performed according to RECIST 1.1. DpR was defined as percentage change in tumour diameter within defined time intervals (induction ther-apy, maintenance therapy, total course of therapy). For prognostic and predictive analyses, median DpR () served as threshold.Results: Out of 248 patients receiving maintenance therapy, 211 were evaluable for DpR an-alyses (FU/FA + Pmab, n = 106;FU/FA alone, n = 105). The overall DpR in all patients was 56.5%. DpR of induction therapy (42.5%) accounted for the largest proportion (75.2%) of the overall DpR. While greater DpR to induction therapy was significantly associated with prolonged PFS (HR 0.70, 95% CI 0.52-0.93, p = 0.013) and OS (HR 0.38, 95% CI 0.28-0.51, p < 0.001), there was no significant correlation of DpR and maintenance treatment arm.Conclusions: In the PanaMa trial, the overall DpR was similar to DpR achieved by other epidermal growth factor receptor-based regimens. DpR to induction therapy accounted for three quarters of the total tumour shrinkage potentially suggesting that FOLFOX plus Pmab can be de-escalated following induction without substantially compromising efficacy. DpR to induction therapy was prognostic but not predictive for efficacy of consecutive maintenance therapy.Clinical trial information: NCT01991873. 2022 Elsevier Ltd. All rights reserved.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0959-8049
• Sprache: Englisch