A randomized phase III trial on maintenance treatment with bevacizumab alone or in combination with erlotinib after chemotherapy and bevacizumab in metastatic colorectal cancer: the Nordic ACT Trial
A Johnsson, H Hagman, J-E Frödin, A Berglund, N Keldsen, E Fernebro, J Sundberg, R De Pont Christensen, K-L Garm Spindler, D Bergström, A Jakobsen, A Johnsson, H Hagman, J-E Frödin, A Berglund, N Keldsen, E Fernebro, J Sundberg, R De Pont Christensen, K-L Garm Spindler, D Bergström, A Jakobsen
Abstract
Background: The main objective was to study the effect on progression-free survival (PFS) of adding erlotinib to bevacizumab as maintenance treatment following chemotherapy and bevacizumab as first-line treatment of metastatic colorectal cancer (mCRC).
Patients and methods: Patients with untreated mCRC received doublet chemotherapy + bevacizumab during 18 weeks and those without tumor progression were eligible for randomization to bevacizumab + erlotinib (arm A) or bevacizumab alone (arm B), until progression or unacceptable toxic effect.
Results: Of the 249 patients enrolled, 80 started maintenance treatment in arm A and 79 in arm B. The rate of any grade 3/4 toxic effect was 53% in arm A and 13% in arm B. Median PFS was 5.7 months in arm A and 4.2 months in arm B (HR = 0.79; 95% confidence interval 0.55-1.12; P = 0.19). Overall survival (OS) from start of induction chemotherapy was 26.7 months in the randomized population, with no difference between the two arms.
Conclusions: The addition of erlotinib to bevacizumab as maintenance treatment after first-line chemotherapy in mCRC did not improve PFS significantly. On-going clinical and translational studies focus on identifying subgroups of patients that may benefit from erlotinib in the maintenance setting.
Clinical trials number: NCT00598156.
Keywords: bevacizumab; erlotinib; maintenance treatment; metastatic colorectal cancer.
Source: PubMed