• Lee S Schwartzberg, Fernando Rivera, Meinolf Karthaus, Gianpiero Fasola, Jean-Luc Canon, J Randolph Hecht, Hua Yu, Kelly S Oliner, and William Y Go.
• Lee S. Schwartzberg, West Clinic, Memphis, TN; Fernando Rivera, Hospital Universitario Marques de Valdecilla, Santander, Spain; Meinolf Karthaus, Städtisches Klinikum München, Klinikum Neuperlach, Munich, Germany; Gianpiero Fasola, University Hospital Santa Maria della Misericordia, Udine, Italy; Jean-Luc Canon, Grand Hopital de Charleroi, Charleroi, Belgium; J. Randolph Hecht, David Geffen School of Medicine at University of California Los Angeles, Los Angeles; and Hua Yu, Kelly S. Oliner, and William Y. Go, Amgen, Thousand Oaks, CA. lschwartzberg@westclinic.com.
• J. Clin. Oncol. 2014 Jul 20;32(21):2240-7.

PurposeTo evaluate panitumumab plus modified fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) or bevacizumab plus mFOLFOX6 in patients with previously untreated wild-type (WT) KRAS exon 2 (codons 12 and 13) metastatic colorectal cancer (mCRC). A prespecified secondary objective was to assess treatment effects in an extended RAS analysis that included exons 2, 3, and 4 of KRAS and NRAS.Patients And MethodsPatients with WT KRAS exon 2 tumors were randomly assigned at a one-to-one ratio to panitumumab plus mFOLFOX6 or bevacizumab plus mFOLFOX6. The primary end point was progression-free survival (PFS); secondary end points included overall survival (OS) and safety.ResultsOf 285 randomly assigned patients, 278 received treatment. In the WT KRAS exon 2 intent-to-treat group, PFS was similar between arms (hazard ratio [HR], 0.87; 95% CI, 0.65 to 1.17; P = .353). Median OS was 34.2 and 24.3 months in the panitumumab and bevacizumab arms, respectively (HR, 0.62; 95% CI, 0.44 to 0.89; P = .009). In the WT RAS subgroup (WT exons 2, 3, and 4 of KRAS and NRAS), PFS favored the panitumumab arm (HR, 0.65; 95% CI, 0.44 to 0.96; P = .029). Median OS was 41.3 and 28.9 months (HR, 0.63; 95% CI, 0.39 to 1.02; P = .058) in the panitumumab and bevacizumab arms, respectively. Treatment discontinuation rates because of adverse events were similar between arms.ConclusionPFS was similar and OS was improved with panitumumab relative to bevacizumab when combined with mFOLFOX6 in patients with WT KRAS exon 2 tumors. Patients with WT RAS tumors seemed to experience more clinical benefit with anti-epidermal growth factor receptor therapy.© 2014 by American Society of Clinical Oncology.

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