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Folfirinox + Cetuximab Chemotherapy, in First Line, With Wild RAS and According to BRAF Status in Metastatic Colorectal Cancer

Completed
Conditions
Colorectal Cancer
Registration Number
NCT03914170
Lead Sponsor
Institut du Cancer de Montpellier - Val d'Aurelle
Brief Summary

This retrospective study, will evaluate patient outcomes after triplet chemotherapy (FOLFIRINOX) (5 Fluorouracil + oxaliplatin + irinotecan) plus cetuximab 1st line treatment focusing on efficacy and safety in a RAS (KRAS, NRAS (neuroblastoma rat sarcoma viral oncogene homolog) wild-type metastatic colorectal cancer population, and according to BRAF (murine sarcoma viral oncogene homolog B) status and primary tumor location.

Detailed Description

In Europe, there are 447,000 new cases of colorectal cancer each year. Approximately 25% of patients present with metastases at initial diagnosis and almost 50% of patients with mCRC (metastatic colorectal cancer) will develop metastases

. Chemotherapy represents the backbone of treatment, and survival is linked with the administration of all three active cytotoxic agents (5-fluorouracil/folinate, oxaliplatin, and irinotecan) in the first line treatment of metastatic colorectal disease.

Monoclonal antibodies such as cetuximab in combination with chemotherapy are a first line treatment option in metastatic RAS (rat sarcoma viral oncogene homolog) wild type metastatic colorectal cancer (mCRC).

Phase II trials evaluating triplet chemotherapy plus cetuximab reported interesting results in terms of efficacy (response rate, resectability...), but at the price of an increased rate of toxic effects.

This retrospective study, will evaluate patient outcomes after triplet chemotherapy (FOLFIRINOX) (5 Fluorouracil + oxaliplatin + irinotecan) plus cetuximab 1st line treatment focusing on efficacy and safety in a RAS (KRAS, NRAS (neuroblastoma rat sarcoma viral oncogene homolog) wild-type mCRC (metastatic colorectal cancer) population, and according to BRAF (murine sarcoma viral oncogene homolog B) status and primary tumor location.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
70
Inclusion Criteria
  1. Colorectal cancer confirmed as RAS wild by tumor tissue analysis
  2. Non resectable and measurable metastatic disease
  3. Patients treated with FOLFIRINOX + cetuximab in first line metastatic disease
  4. Males or females aged over 18 years.
Exclusion Criteria
  1. Known brain metastases
  2. RAS not assessable (e.g., material not available or insufficient)
  3. The first administration of cetuximab was more than 30 days after the first administration of FOLFIRINOX
  4. History of other malignancy in the last 5 years. Patients with prior history of in situ cancer or basal or squamous cell skin cancer are eligible. Patients with other malignancies are eligible if they were cured by surgery alone or surgery plus radiotherapy and have been continuously disease-free for at least 5 years

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Median Progression free survival (PFS)Approximately 36 months

In RAS wt population

Secondary Outcome Measures
NameTimeMethod
Progression free survival (PFS)9 months

Rates in RAS wt population

Liver metastases resection rateMaximal 6 months

Resection (R0 / R1 / R2)

Overall Response RateMaximal 6 months

at the end of 1st line treatment evaluated according RECIST ( Response Evaluation Criteria in Solid Tumours)

Overall SurvivalApproximately 36 months

Defined as the time from the date of initial first line treatment initiation to the date of documented death from any cause

Duration of responseApproximately 36 months
Assessment of adverse events by using the NCI-CTCAE version 4.0 scaleMaximal 6 months

Maximum grade observed throughout the treatment

Trial Locations

Locations (1)

Institut régional du cancer de Montpellier

🇫🇷

Montpellier, Hérault, France

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