Abstract 441P
Background
FIRE-3 compared first-line therapy with FOLFIRI plus either cetuximab or bevacizumab in RAS wild-type mCRC patients. Here, we investigated the subgroup of patients that underwent secondary mestastasectomy in curative intent to explore the relevance of conversion treatment based on anti-EGFR- versus anti-VEGF directed antibodies.
Methods
Patients who underwent resection in curative intent defined as reason for end of study treatment and bearing a RAS wild-type tumor within the FIRE-3 study were investigated. For those a retrospective, unplanned analysis was done comparing cetuximab and bevacizumab treated patients. Median survival times were estimated using the Kaplan-Meier method and compared using the logrank test.
Results
Within the extended RAS wild-type population of 400 patients, 25 out of 199 patients treated with cetuximab and 26 out of 201 patients treated with bevacizumab were resected in curative intent. Median PFS was 10.9 months (95% CI: 6.4 – 15.5 months) in the cetuximab arm and 12.8 months (95% CI: 11.9 – 13.6 months) in the bevacizumab-arm (logrank P = 0.95). Median OS reached 56.9 months (95% CI: 53.7 – 60.0 months) and 38.1 months (95% CI: 11.9 – 64.3 months), respectively (P= 0.19). Overall survival after resection was 40.7 months (95% CI: 16.7 – 64.7 months) in the cetuximab arm and 19.4 months (95% CI: 16.0 - 22.2 months) in bevacizumab treated patients (P= 0.19).
Conclusions
Patients undergoing secondary resection in curative intent within the FIRE-3 trial had a numerically longer postsurgical survival and longer overall survival when treated with FOLFIRI plus cetuximab compared to FOLFIRI plus bevacizumab.
Clinical trial identification
NCT00433927.
Editorial acknowledgement
Legal entity responsible for the study
Volker Heinemann.
Funding
Merck KGaA, Darmstadt, Germany.
Disclosure
All authors have declared no conflicts of interest.