Phase II APEC trial: The impact of primary tumor side on outcomes of first-line cetuximab plus FOLFOX or FOLFIRI in patients with RAS wild-type metastatic colorectal cancer
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AbstractAIM:
The open-label, nonrandomized, phase II APEC study enrolled 167 patients with RAS wild-type (wt) metastatic colorectal cancer (mCRC) to investigate the safety and efficacy of first-line, every-2-weeks cetuximab plus investigator's choice of FOLFIRI or FOLFOX in this patient population.

METHODS:
A subgroup analysis of the APEC study population by primary tumor location was performed.

RESULTS:
A total of 130 patients (81.8%) had left-sided and 29 (18.2%) had right-sided mCRC. Median progression-free survival (PFS), overall survival (OS) and overall response rate (ORR) were 14.0 months, 30.6 months and 68.5% for patients with left-sided tumors and 8.9 months, 24.6 months and 51.7% for patients with right-sided mCRC, concurring with pivotal phase III trial results. In patients with right-sided tumors, median PFS was 15.4 months vs 8.3 months with cetuximab plus FOLFIRI vs cetuximab plus FOLFOX, respectively; median OS was 32.1 months vs 21.8 months with cetuximab plus FOLFIRI vs cetuximab plus FOLFOX, respectively.

CONCLUSION:
The APEC tumor-location subgroup analysis results were largely consistent with available literature regarding the equivalent efficacy of cetuximab plus FOLFIRI/FOLFOX in patients with left-sided RAS wt mCRC. A trend toward improved efficacy with cetuximab plus FOLFIRI compared with cetuximab plus FOLFOX was observed in patients with right-sided tumors; however, a direct comparison between groups cannot be made due to the nonrandomized study design. Nevertheless, the similar ORR observed with either chemotherapy backbone in patients with right-sided RAS wt mCRC suggests a potential role for both regimens in this patient population when cytoreduction is a treatment goal.
Acceptance Date25/03/2019
All Author(s) ListPrice T, Shen L, Ma B, Esser R, Chen W, Gibbs P, Lim R, Cheng AL
Journal nameAsia-Pacific Journal of Clinical Oncology
Detailed descriptionEpub 2019 May 15
Year2019
Month8
Volume Number15
Issue Number4
PublisherWiley
Pages225 - 230
ISSN1743-7555
eISSN1743-7563
LanguagesEnglish-United Kingdom
Keywordscetuximab, metastatic colorectal cancer, tumor location

Last updated on 2020-21-09 at 02:05