Colorectal liver metastasis: bevacizumab vs cetuximab in head-to-head trial

  • Oki E & al.
  • Br J Cancer
  • 09.07.2019

  • von Jim Kling
  • Univadis Clinical Summaries
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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.