Response-independent survival benefit in metastatic colorectal cancer: a comparative analysis of N9741 and AVF2107.

Response-independent survival benefit in metastatic colorectal cancer: a comparative analysis of N9741 and AVF2107. Research Abstract Details 

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Response-independent survival benefit in metastatic colorectal cancer: a comparative analysis of N9741 and AVF2107. Abstract Text:

Axel Grothey,Eric E Hedrick,Robert D Mass,Somnath Sarkar,Sam Suzuki,Ramesh K Ramanathan,Herbert I Hurwitz,Richard M Goldberg,Daniel J Sargent,Axel Grothey,Eric E Hedrick,Robert D Mass,Somnath Sarkar,Sam Suzuki,Ramesh K Ramanathan,Herbert I Hurwitz,Richard M Goldberg,Daniel J Sargent,

PURPOSE: In the phase III study AVF2107g, bevacizumab (BV) demonstrated a survival benefit when added to irinotecan, fluorouracil, and leucovorin (IFL) in first-line metastatic colorectal cancer (mCRC). In a parallel phase III study, Intergroup N9741, oxaliplatin plus fluorouracil and leucovorin (FOLFOX) also demonstrated a survival benefit compared with IFL. As these two superior therapies have differing mechanisms of action, we explored whether the improved survival associated with the superior therapy was dependent on tumor response. PATIENTS AND METHODS: For these retrospective, exploratory analyses, patients were defined as responders or nonresponders by whether complete or partial response was achieved with first-line therapy. RESULTS: Compared with IFL alone, BV plus IFL and FOLFOX each demonstrated statistically significant improvements in progression-free survival (PFS) and overall survival (OS) regardless of objective tumor response. BV-treated nonresponders had a hazard ratio (HR) of 0.63 (P = .0001) for PFS and 0.76 (P = .0188) for OS compared with IFL-treated nonresponders. FOLFOX-treated nonresponders had an HR of 0.75 (P = .0029) for PFS and 0.74 (P = .0030) for OS compared with IFL-treated nonresponders. CONCLUSION: In both AVF2107g and N9741, objective response did not predict the magnitude of PFS or OS benefit from the superior therapy; nonresponders, despite a poorer prognosis than responders, achieved extended PFS and OS from BV plus IFL or FOLFOX compared with IFL. On the basis of these data, tumor response in metastatic colorectal cancer is not a necessary factor for a therapy to provide benefit to an individual patient.

Response-independent survival benefit in metastatic colorectal cancer: a comparative analysis of N9741 and AVF2107. Publishing Authors By Initials

A Grothey,EE Hedrick,RD Mass,S Sarkar,S Suzuki,RK Ramanathan,HI Hurwitz,RM Goldberg,DJ Sargent,A Grothey,EE Hedrick,RD Mass,S Sarkar,S Suzuki,RK Ramanathan,HI Hurwitz,RM Goldberg,DJ Sargent,

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Response-independent survival benefit in metastatic colorectal cancer: a comparative analysis of N9741 and AVF2107. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Journal of clinical oncology : official journal of

VOLUME: 26

Page Numbers: 183-9

Journal Abbreviation: J. Clin. Oncol.

ISSN: 1527-7755

DAY: 10

MONTH: Jan

YEAR: 2008

Response-independent survival benefit in metastatic colorectal cancer: a comparative analysis of N9741 and AVF2107. Information

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LANGUAGE: eng

NlmUniqueID: 8309333

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Grant and Affiliation Information for Response-independent survival benefit in metastatic colorectal cancer: a comparative analysis of N9741 and AVF2107.

AFFILIATION: Corresponding author: Axel Grothey, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, USA. grothey.axel@mayo.edu

Country: United States

AGENCY: United States NCI

GRANT: CA25224

ACRONYM: CA

MEDLINETA: J Clin Oncol

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