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Proffered paper session - Gastrointestinal tumours, colorectal

6611 - Fluoropyrimidine (FP) + bevacizumab (BEV) + atezolizumab vs FP/BEV in BRAFwt metastatic colorectal cancer (mCRC): Findings from Cohort 2 of MODUL – a multicentre, randomized trial of biomarker-driven maintenance treatment following first-line induction therapy


22 Oct 2018


Proffered paper session - Gastrointestinal tumours, colorectal


Targeted Therapy;  Immunotherapy

Tumour Site

Colon and Rectal Cancer


Axel Grothey


A. Grothey1, J. Tabernero2, D. Arnold3, A. De Gramont4, M.P. Ducreux5, P.J. O'Dwyer6, E. van Cutsem7, I. Bosanac8, S. Srock8, C. Mancao8, F. Gilberg8, J. Winter8, H. Schmoll9

Author affiliations

  • 1 Division Of Medical Oncology, West Cancer Center, 38138 - Germantown/US
  • 2 Medical Oncology, Vall d’Hebron University Hospital. Vall d’Hebron Institute of Oncology VHIO., 08035 - Barcelona/ES
  • 3 2. Med. Abteilung, Asklepios Klinik Altona, 22763 - Hamburg/DE
  • 4 Medical Oncology, Institut hospitalier Franco-Britannique, 92300 - Levallois Perret/FR
  • 5 Medical Oncology, Gustave Roussy - Cancer Campus, 94805 - Villejuif/FR
  • 6 Medical Oncology, University of Pennsylvania, 19104 - Philadelphia/US
  • 7 Digestive Oncology, University Hospitals Gasthuisberg/Leuven and KULeuven, 3000 - Leuven/BE
  • 8 Medical Affairs, F. Hoffmann-La Roche Ltd, Basel/CH
  • 9 Medical Oncology, Martin-Luther-University, Halle/DE


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Abstract 6611


In patients (pts) with mCRC, molecular screening approaches and new biomarkers are required to fully characterize tumours and identify those likely to benefit. The MODUL study (ClinicalTrials.gov: NCT02291289) is highly adaptable, Phase II signal seeking, and evaluates the theory of tumoural heterogeneity under induction chemotherapy via switch maintenance treatment in first-line mCRC.


MODUL follows an umbrella design; pts with measurable, unresectable, previously untreated mCRC receive 16 weeks of induction treatment with FOLFOX + BEV followed by maintenance randomized to either control (FP/BEV) or experimental treatment in one of four cohorts. Here we report results of Cohort 2 (BRAFwt: FP/BEV + atezolizumab). Primary efficacy endpoint: progression-free survival (PFS, per investigator). Secondary endpoints: overall survival (OS); best overall response rate (ORR); disease control rate (DCR); time to treatment response (TTR); duration of response (DoR); ECOG performance status (PS); safety.


824 pts were screened, 696 of whom were enrolled to receive induction treatment. 445 pts with BRAFwt mCRC were randomized to maintenance treatment in Cohort 2 (297 pts FP/BEV + atezolizumab; 148 pts FP/BEV). In the primary analysis of Cohort 2 (median follow-up 10.5 months), PFS was not met (HR=0.92; 95% CI 0.72–1.17; p=0.48) and OS was immature. ORR, DCR, TTP and DoR showed small numerical differences in favour of experimental treatment. Subgroup treatment interactions were observed for gender, ECOG PS, response at end of induction and initial diagnosis (synchronous vs metachronous disease). In the updated analysis (median follow-up 18.7 months), PFS outcome was unchanged (HR=0.96; 95% CI 0.77–1.20; p=0.727) and OS with 51% of pts with an event was HR=0.86; 95% CI 0.66–1.13; p=0.28. The safety profiles observed are consistent with previous findings with no new safety signals identified.


Adding atezolizumab to FP/BEV (standard of care) as first-line maintenance treatment for pts with BRAFwt mCRC did not lead to improvement in efficacy outcomes.

Clinical trial identification

ClinicalTrials.gov: NCT02291289

Editorial Acknowledgement

Editorial assistance was provided by Lee Miller (Miller Medical Communications).

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