Takeaway
- Cetuximab yielded a better response rate but similar resection rates vs bevacizumab in a head-to-head trial of patients receiving frontline mFOLFOX6 for colorectal liver metastasis.
Why this matters
- The study is the first direct comparison between an antiepidermal growth factor receptor and an antivascular endothelial growth factor agent in this population.
Study design
- Phase 2 randomized controlled trial (n=122).
- Funding: Chugai Pharmaceutical Co. Ltd, Japan.
Key results
- Median follow-up, 24.3 months.
- PFS was 14.8 (95% CI, 9.7-17.3) months in the cetuximab group compared with 11.5 (95% CI, 9.2-13.3) months in the bevacizumab group (log-rank P=.33).
- Median OS was not significantly different (bevacizumab HR, 0.827; 95% CI, 0.437-1.564).
- Subgroup analyses showed better PFS with cetuximab among patients with 1-4 liver metastases (HR, 0.260; 95% CI, 0.084-0.811).
- Overall response rate was higher in the cetuximab group (84.7% vs 68.4%; P=.0483).
- 40.4% of patients in the bevacizumab group had grade ≥3 subjective or objective toxicity events compared with 52.5% in the cetuximab group. The most common was neutropenia, with an incidence of 36.8% in the bevacizumab group and 50.8% in the cetuximab group.
Limitations
- Small study.
- Japanese population.
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