For the initial (first-line) treatment of metastatic colorectal cancer with no KRAS gene mutations, the combination of Erbitux® (cetuximab) and FOLFIRI chemotherapy was more effective than the combination of Avastin® (bevacizumab) and FOLFIRI. These results were presented at the 2013 Annual Meeting of the American Society of Clinical Oncology.
Erbitux and Avastin are both targeted therapies that have been approved for selected patients with metastatic colorectal cancer. Avastin blocks a protein known as VEGF, and Erbitux blocks a protein known as EGFR. Both of these proteins play a role in cancer growth.
To compare these two drugs for the initial treatment of patients with metastatic colorectal cancer, researchers in Germany conducted a Phase III clinical trial (the FIRE-3 trial) among 592 patients. Because Erbitux is not used for cancers that contain certain gene mutations (KRAS mutations), none of the patients had these mutations. All of the study participants were treated with a chemotherapy regimen known as FOLFIRI, and patients also received treatment with either Avastin or Erbitux.
- Time to cancer progression (worsening of the cancer) was roughly 10 months in both study groups.
- Overall survival was better in the group that got Erbitux plus FOLFIRI (28.7 months) than in the group that got Avastin plus FOLFIRI (25.0 months).
These results suggest that Erbitux is more effective than Avastin when used in combination with FOLFIRI chemotherapy for the initial treatment of KRAS mutation-negative, metastatic colorectal cancer.
FOLFOX is another chemotherapy regimen that is commonly used in the United States, and a clinical trial to compare Erbitux and Avastin in combination with FOLFOX is currently underway.
Reference: Heinemann V, von Weikersthal LF, Decker T et al. Randomized comparison of FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab as first-line treatment of KRAS-wildtype metastatic colorectal cancer: German AIO study KRK-0306 (FIRE-3). Presented at the 49th Annual Meeting of the American Society of Clinical Oncology. May 31-June 4, 2013; Chicago, IL. Abstract LBA3506.
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