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Randomized phase III study of irinotecan and 5-FU/FA with or without cetuximab in the first-line treatment of patients with metastatic colorectal cancer (mCRC): The CRYSTAL trial.

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Sub-category:
Colorectal Cancer (including liver metastases)

Category:
Gastrointestinal (Colorectal) Cancer

Meeting:
2007 ASCO Annual Meeting

Abstract No:
4000

Citation:
Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings Part I. Vol 25, No. 18S (June 20 Supplement), 2007: 4000

Author(s):
E. Van Cutsem, M. Nowacki, I. Lang, S. Cascinu, I. Shchepotin, J. Maurel, P. Rougier, D. Cunningham, J. Nippgen, C. Köhne

Abstract:

Background: Cetuximab in combination with irinotecan-based regimens has proven activity in previously-treated patients (pts) with mCRC. The present trial investigated the effectiveness of cetuximab in combination with standard FOLFIRI compared with FOLFIRI alone in the first-line treatment of pts with epidermal growth factor receptor (EGFR)-expressing mCRC. Methods: Pts were randomized 1:1 to receive either cetuximab (400 mg/m2 initial dose then 250 mg/m2/week [w]) plus FOLFIRI q 2 w (irinotecan 180 mg/m2, FA 400 mg/m2, 5-FU bolus 400 mg/m2, 5-FU infusion 2,400 mg/m2 over 46 hours) (Group A) or FOLFIRI alone (Group B). The primary endpoint was progression-free survival (PFS), with secondary endpoints of overall survival (OS), response rate (RR), disease control rate and safety. 633 events were required to statistically differentiate PFS between groups with 80% power. Results: Between August 2004 and October 2005, 1,217 pts were randomized, 608 to Group A and 609 to Group B (60% male, median age 61 [19-84], ECOG performance status: 0=54%; 1=43.5%; 2=3.5%). Median PFS was significantly longer for Group A compared to Group B (8,9 months [8 - 9,5] for Group A vs. 8 months [7.6 - 9] for Group B, p=0.036). Response Rate was also significantly increased by cetuximab (46.9% vs. 38.7%, p=0.005). Treatment was generally well tolerated with neutropenia (26.7% Group A, 23.3% Group B), diarrhea (15.2% and 10.5% respectively) and skin reactions (18.7% and 0.2% respectively) being the most common grade 3/4 adverse events. Conclusions: Cetuximab in combination with FOLFIRI significantly increases response rate and significantly prolongs PFS in the first-line treatment of pts with mCRC, reducing the relative risk of progression by approximately 15%. Treatment-related side effects of cetuximab in combination with FOLFIRI were as expected, with diarrhea being moderately and skin reactions significantly more frequent as compared to FOLFIRI alone.


Abstract Disclosures

Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy and are designated with a caret symbol (^) here and in the print version.


  Associated Presentation(s):

    

1. Gastrointestinal (Colorectal) Cancer

Meeting: 2007 Best of ASCO San Francisco
Speaker: Jean Grem, MD
Session: 2007 Best of ASCO San Francisco

    

2. Gastrointestinal (Colorectal) Cancer

Meeting: 2007 Best of ASCO Reston
Speaker: Al Benson, MD
Session: 2007 Best of ASCO Reston

    

3. Randomized phase III study of irinotecan and 5-FU/FA with or without cetuximab in the first-line treatment of patients with metastatic colorectal cancer (mCRC): The CRYSTAL trial.

Meeting: 2007 ASCO Annual Meeting
Presenter: Eric Van Cutsem, MD, PhD
Session: The Epidermal Growth Factor Receptor as a Therapeutic Target in Gastrointestinal Malignancy (Clinical Science Symposium)


  Other Abstracts in this Sub-Category:

    

1. Final results of the EORTC Intergroup randomized phase III study 40983 [EPOC] evaluating the benefit of peri-operative FOLFOX4 chemotherapy for patients with potentially resectable colorectal cancer liver metastases.

Meeting: 2007 ASCO Annual Meeting   Abstract No: LBA5   First Author: B. Nordlinger
Category: Gastrointestinal (Colorectal) Cancer - Colorectal Cancer (including liver metastases)

    

2. Quality of life in patients with advanced colorectal cancer treated with cetuximab: Results of the NCIC CTG and AGITG CO.17 trial.

Meeting: 2007 ASCO Annual Meeting   Abstract No: 4002   First Author: H. Au
Category: Gastrointestinal (Colorectal) Cancer - Colorectal Cancer (including liver metastases)

    

3. Impact on quality of life of adding cetuximab to irinotecan in patients who have failed prior oxaliplatin-based therapy: The EPIC trial.

Meeting: 2007 ASCO Annual Meeting   Abstract No: 4003   First Author: C. Eng
Category: Gastrointestinal (Colorectal) Cancer - Colorectal Cancer (including liver metastases)

    

More...


  Abstracts by E. Van Cutsem:

    

1. Adjuvant gemcitabine alone versus gemcitabine-based chemoradiation after curative resection for pancreatic cancer: Updated results of a randomized EORTC/FFCD/GERCOR phase II study (40013-22012/9203).

Meeting: 2009 ASCO Annual Meeting   Abstract No: 4527   First Author: J. L. Van Laethem
Category: Gastrointestinal (Noncolorectal) Cancer - Pancreatic Cancer

    

2. Cetuximab plus FOLFIRI first line in patients (pts) with metastatic colorectal cancer (mCRC): A quality-of-life (QoL) analysis of the CRYSTAL trial.

Meeting: 2009 ASCO Annual Meeting   Abstract No: 4076   First Author: G. Folprecht
Category: Gastrointestinal (Colorectal) Cancer - Colorectal Cancer (including liver metastases)

    

3. DUSPs as markers of MEK/Erk activation in primary colorectal cancer.

Meeting: 2009 ASCO Annual Meeting   Abstract No: 4064   First Author: W. De Roock
Category: Gastrointestinal (Colorectal) Cancer - Colorectal Cancer (including liver metastases)

    

More...


  Presentations by E. Van Cutsem:

    

1. Gastrointestinal Colorectal Carcinoma

Meeting: 2000 ASCO Annual Meeting
Discussant: Eric Van Cutsem, MD, PhD
Session: Gastrointestinal Colorectal Carcinoma

    

2. Colorectal Cancer I

Meeting: 1999 ASCO Annual Meeting
Presenter: Eric Van Cutsem, MD, PhD
Session: Colorectal Cancer I

    

More...


  Educational Book Manuscripts by E. Van Cutsem:

    

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