Abstract 117P
Background
First-line (1L) treatment options for LS RASwt mCRC include the addition of epidermal growth factor receptor inhibitors (EGFRi) to chemotherapy (CT), supported by the overall survival advantage versus CT + bevacizumab (BEV) demonstrated recently in PARADIGM, the first phase 3 trial with pre-planned analysis by tumour side. Treatment selection and outcomes in Australasian routine practice has yet to be described.
Methods
Data from 1/2015 – 5/2023 on patients with LS RASwt mCRC who received 1L doublet CT for palliative intent was reviewed from TRACC, a prospective, multi-site Australasian registry. Baseline clinicopathological characteristics and survival outcomes were analysed with p ≤0.05 denoted as statistical significance.
Results
Of 676 LS RASwt, palliative intent, mCRC patients, 573 (85%) were actively treated, 404 (60%) receiving 1L doublet CT. Of these, 193 (48%) also received EGFRi and 120 (30%) also received BEV. Compared to BEV, patients receiving 1L EGFRi trended towards younger age (57 vs 61 years, p=0.07), were more often Stage IV at diagnosis (80% vs 70%, p=0.05), and less likely to have a BRAF mutant tumour (5% vs 17%, p=0.002). Median progression-free survival (PFS) was 11.7, 9.7 and 10.9 months for EGFRi + doublet CT, BEV + doublet CT and doublet CT alone respectively (HR 0.86 [0.67-1.12], p=0.06 for EGFRi + doublet CT versus BEV + doublet CT). Median overall survival (OS) was 38.1, 29.8 and 31.0 months for EGFRi + doublet CT, BEV + doublet CT and doublet CT alone respectively (HR 0.78 [0.58-1.07], p=0.12 for EGFRi + doublet CT versus BEV). Second-line (2L) PFS was similar for initial EGFRi (n=50 patients) then BEV versus opposite (n=32 patients) sequence (9.7 vs 8.0 months, p=0.55). Notably 24% of patients did not receive an EGFRi in 1L or 2L.
Conclusions
In Australasian practice, 1 in 2 patients with LS RASwt mCRC received 1L treatment with EGFRi + doublet CT, with trends toward improved PFS and OS versus BEV + doublet CT. 1 in 4 patients never received an EGFRi in 1L or 2L treatment, with further research required to understand clinician rationale for reserving active targeted treatments to later line settings.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
WEHI.
Funding
Merck.
Disclosure
V. Wong, B.B.Y. Ma: Financial Interests, Institutional, Research Funding: Merck Serono. All other authors have declared no conflicts of interest.
Resources from the same session
73TiP - Global phase III studies evaluating vepdegestrant in estrogen receptor (ER)+/human epidermal growth factor receptor 2 (HER2)- advanced breast cancer: VERITAC-2 and VERITAC-3
Presenter: Hiroji Iwata
Session: Poster Display
Resources:
Abstract
78P - First-in-human phase I study of TT-00434, an orally available FGFR (1-3) inhibitor in patients with advanced solid tumors
Presenter: Chia Jui Yen
Session: Poster Display
Resources:
Abstract
79P - Accelerated identification of recurrent neoantigens for the development of off-the-shelf cancer vaccines
Presenter: Le Son Tran
Session: Poster Display
Resources:
Abstract
80P - Safety, preliminary efficacy, and pharmacokinetics of HLX26 plus serplulimab in advanced solid tumours: An open-label, dose-escalation phase I study
Presenter: Yanmin Wu
Session: Poster Display
Resources:
Abstract
81P - A first-in-human, multiple dose and dose escalation phase I study to investigate the safety, tolerability and antitumor activity of SmarT cells plus PD-1 blocking antibodies in patients with far advanced/metastatic solid tumors
Presenter: Qin Liu
Session: Poster Display
Resources:
Abstract
82P - NEXUS: A phase I dose escalation study of selinexor plus nivolumab and ipilimumab in Asian patients with advanced/metastatic solid malignancies
Presenter: Gloria Chan
Session: Poster Display
Resources:
Abstract
83P - The updated report of phase I trial of VG2025, a non-attenuated HSV-1 oncolytic virus expressing IL-12 and IL-15/RA payloads, in patients with advanced solid tumors
Presenter: Yinan Shen
Session: Poster Display
Resources:
Abstract
84P - T cell receptor repertoire profiles of tumor -infiltrating lymphocytes improves neoantigen prioritization for personalized cancer immunotherapy
Presenter: Tran Nguyen
Session: Poster Display
Resources:
Abstract
85P - Oligometastatic solid tumors: Disease characteristics and role of local therapies
Presenter: Alshimaa Al Hanafy
Session: Poster Display
Resources:
Abstract
86P - Efficacy and safety of HLX07 monotherapy in advanced cutaneous squamous cell carcinoma: An open-label, multicentre phase II study
Presenter: Changxing Li
Session: Poster Display
Resources:
Abstract