What is the best cytotoxic backbone for biological therapy in mCRC?

Speaker: Eric Van Cutsem

E. Van Cutsem comments on results of German-Austrian FIRE-3 and USA Intergroup 80405 studies with an objective analysis of responses to understand when longer survival may be achieved. Full Ras analysis is missing but it is expected that expanded Ras testing will tell which biological drug (bevacizumab or cetuximab) should be selected. In KRAS only tested population a similar survival was found.

Discussion Points

  • What do results of the CALGB/SWOG 80405 study indicate for first-line treatment of patients with KRAS Wild-type (wt) metastatic adenocarcinoma of the colon?
  • Is there any subset of patients who may get more or less benefit from a specific regimen?
  • How can expanded RAS testing potentially change the study results?
  • Topline results of post-hoc analysis of FIRE-3 trial in second-line application of monoclonal antibodies in patients with KRAS wild-type metastatic colorectal cancer (mCRC)
  • Overall message and impact on current treatment guidelines

Abstracts Discussed

2nd-line therapies after 1st-line therapy with FOLFIRI in combination with cetuximab or bevacizumab in patients with KRAS wild-type metastatic colorectal cancer (mCRC)-analysis of the AIO KRK 0306 (FIRE 3)- trial

CALGB/SWOG 80405: PHASE III trial of irinotecan/5-FU/leucovorin (FOLFIRI) or oxaliplatin/5-FU/leucovorin (mFOLFOX6) with bevacizumab (BV) or cetuximab (CET) for patients (pts) with KRAS wild-type (wt) untreated metastatic adenocarcinoma of the colon