Cetuximab Plus FOLFIRINOX (ERBIRINOX) as First-Line Treatment for Unresectable Metastatic Colorectal Cancer: A Phase II Trial

Assenat, Éric; Desseigne, Françoise; Thézenas, Simon; Viret, F.; Mineur, Laurent; Kramar, Andrew; Samalin, Emmanuelle; Portales, Fabienne; Bibeau, Frédéric; Crapez-Lopez, Evelyne; Bleuse, Jean-Pierre; Ychou, Marc

doi:10.1634/theoncologist.2011-0141

Cited by 77 publications

(70 citation statements)

References 28 publications

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“…Such treatment has become the standard first-line therapy for oligometastatic CRC patients when there is a possibility of surgery of metastases [33]. The association with bevacizumab [34] and cetuximab [35] was tested in a phase II trial and demonstrates impressive efficacy. The efficacy of triplet chemotherapy without biotherapy was tested in some patients previously pretreated with either oxaliplatin or irinotecan in a phase I study.…”

Section: Discussionmentioning

confidence: 99%

FOLFIRINOX Bevacizumab Is a Promising Therapy for Chemorefractory Metastatic Colorectal Cancer

Chaix

Vincent²,

Lorgis³

et al. 2014

Oncology

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Purpose: Fluoropyrimidines, oxaliplatin, irinotecan and targeted therapies represent the standard treatment of metastatic colorectal cancer. After failure of all these treatments, few options are available. In such chemorefractory patients the effect of triplet chemotherapy with bevacizumab (FOLFIRINOX bevacizumab) has never been investigated. Patients and Methods: 49 consecutive patients bearing unresectable metastatic colorectal cancer and who experienced failure to oxaliplatin- and irinotecan-based chemotherapy were treated with oxaliplatin (85 mg/m²), irinotecan (180 mg/m²), leucovorin (400 mg/m²), and fluorouracil (400 mg/m² bolus then 2,400 mg/m²) repeated every 2 weeks. Results: Median age was 63 (range 36-82) years. After a median follow-up of 12 months, the median progression-free survival was 5.8 months (95% CI 3.4-6.8) and the median overall survival was 11.9 months (95% CI 8-18). The response rate after the cycle was evaluable for 36 patients, whereby we observed 18% (95% CI 8-35) partial or complete response, 45% (95% CI 28-68) stable disease of more than 2 months, and 37% (95% CI 21-58) progression. Conclusion: This study suggests that bevacizumab + FOLFIRINOX may be active in mCRC patients after failure of classical lines of chemotherapy.

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Section: Discussionmentioning

confidence: 99%

FOLFIRINOX Bevacizumab Is a Promising Therapy for Chemorefractory Metastatic Colorectal Cancer

Chaix

Vincent²,

Lorgis³

et al. 2014

Oncology

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“…Overall, the use of FOLFOXIRI plus cetuximab or pani tumumab achieved remark able results in terms of anti cancer activity and secondary resection rates. Promising evidence of the clinical activity of three-drug chemo therapy plus cetuximab regimens was initially observed in mol ecularly unselected populations in the POCHER, ERBIRINOX and COFI trials (ORR of 79%, 81%, and 75%, respectively), [61][62][63] and then replicated in patients with wild-type KRAS exon 2. 64,65 For example, the phase II trial by Saridaki and colleagues, 64 which evaluated a modified FOLFOXIRI regimen plus cetuximab in 30 patients with KRAS-exon-2-wild-type mCRC, reported an ORR and a radical resection rate of 70% and 37%, respectively.…”

Section: Combination With Anti-egfr Agentsmentioning

confidence: 99%

First-line chemotherapy for mCRC—a review and evidence-based algorithm

et al. 2015

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The response to first-line therapy is a primary determinant of outcome in patients with metastatic colorectal cancer (mCRC), for three main reasons: effective upfront therapy provides a unique opportunity to cure some patients; can be crucial in delaying disease progression and achieving symptom relief; and can improve patient eligibility for, and the effectiveness of, further treatments. In the past decade, decision-making regarding the choice of first-line therapy for mCRC has been complicated by the availability of many different options without a definitive consensus on a specific standard of care (despite major advances in categorizing predictive molecular disease subtypes). Most of the efforts of the scientific community have been directed at establishing the best biologic agent to be combined with a chemotherapy doublet, although a different branch of research has produced new data that underscore the importance of defining the optimal chemotherapy backbone. Herein, we review the key clinical trials completed in the past 10 years that have investigated and compared the use of chemotherapy doublets, triplets, and monotherapies, with or without molecularly targeted biologic agents, in the first-line treatment of patients with mCRC. Our examination of the literature led us to propose a new patient-oriented algorithm to guide clinicians' decisions on the best choice of upfront therapy for mCRC.

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“…As yet, there is no established standard of care for the neoadjuvant treatment of resectable, borderline or locally advanced PDAC. Recently the standard of care in the metastatic setting has been improved by the FOLFIRINOX protocol [12], a combination of 5-fluorouracil (5-FU), leucovorin, irinotecan and oxaliplatin that was first examined in colorectal cancer [13,14] and by the combination of gemcitabine plus nanoparticle albumin-bound paclitaxel (nab-paclitaxel) [15]. Both regimens are superior to the standard of single-agent gemcitabine [12,15].…”

Section: Introductionmentioning

confidence: 99%

“…Apart from conventional chemotherapies, various targeted therapies including anti-EGFR, anti-VEGF and anti-Her2 antibodies have become the standard of care for certain types of colorectal or gastric cancer [13,16,17,18,19]. However, despite numerous large clinical trials, no targeted therapy has as yet demonstrated clinical benefit in PDAC apart from the tyrosine kinase inhibitor erlotinib in combination with gemcitabine [20].…”

Section: Introductionmentioning

confidence: 99%

Pancreatic Cancer: Progress in Systemic Therapy

Perkhofer

Ettrich

Seufferlein

2014

Gastrointest Tumors

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Background: Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer-related deaths in the Western world. Due to lack of specific symptoms and no accessible precursor lesions, primary diagnosis is commonly delayed, resulting in the identification of only 15-20% of patients with potentially curable disease. The major limiting factor is an already locally advanced or metastatic disease at the time of diagnosis. Consequently, systemic therapy forms the backbone of treatment strategy for the majority of patients. Summary: A deeper understanding of the molecular characteristics of pancreatic cancer has led to the identification of several potential therapeutic targets. A variety of targeted therapies are currently under clinical evaluation as single agents or in combination with chemotherapy for PDAC. This review highlights the current state of chemotherapy in pancreatic cancer and provides an outlook on its future perspectives. Key Message: This review focuses on the current chemotherapy regimens for the systemic treatment of PDAC. Practical Implications: Various neoadjuvant approaches have been explored, including chemoradiation, chemotherapy followed by chemoradiation or intensified chemotherapy without defining a standard of care so far. The standard of care is gemcitabine or 5-fluorouracil. The oral fluoropyrimidine S-1 may be a promising new agent in this setting. For first-line treatment of metastatic pancreatic cancer, no targeted therapy has yet demonstrated clinical benefit apart from the combination of the tyrosine kinase inhibitor erlotinib plus gemcitabine. Recently, novel chemotherapeutic regimens such as FOLFIRINOX and gemcitabine plus nanoparticle albumin-bound paclitaxel have been introduced. Both combinations have proved to be superior to the standard gemcitabine regimen. For second-line treatment the combination of 5-fluorouracil/leucovorin and oxaliplatin yields improved results compared to best supportive care.

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Cetuximab Plus FOLFIRINOX (ERBIRINOX) as First-Line Treatment for Unresectable Metastatic Colorectal Cancer: A Phase II Trial

Cited by 77 publications

References 28 publications

FOLFIRINOX Bevacizumab Is a Promising Therapy for Chemorefractory Metastatic Colorectal Cancer

FOLFIRINOX Bevacizumab Is a Promising Therapy for Chemorefractory Metastatic Colorectal Cancer

First-line chemotherapy for mCRC—a review and evidence-based algorithm

Pancreatic Cancer: Progress in Systemic Therapy

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