Randomized Study of Etirinotecan Pegol Versus Irinotecan As Second-line Treatment for Metastatic Colorectal Cancer

Overview

Journal Cancer Chemother Pharmacol

Specialty Oncology

Date 2017 Oct 19

PMID 29043412

Citations 4

Authors

Heinz-Josef Lenz

Philip Philip

Mark Saunders

Tatjana Kolevska

Kalyan Mukherjee

Leslie Samuel

Shailesh Bondarde

Tracy Dobbs

Mary Tagliaferri

Ute Hoch

Alison L Hannah

Maurice Berkowitz

Affiliations

Soon will be listed here.

Abstract

Purpose: Etirinotecan pegol (EP) is a long-acting topoisomerase-I inhibitor designed to provide sustained exposure to SN-38 (active metabolite of irinotecan). This phase II study compared EP versus irinotecan as second-line treatment for KRAS-mutant, irinotecan-naïve, metastatic colorectal cancer (mCRC).

Methods: Patients were randomized to EP 145 mg/m or irinotecan 350 mg/m Q21d until disease progression/unacceptable toxicity. The primary endpoint was progression-free survival (PFS) with response determined by central radiologic review (RECIST version 1.1).

Results: The study was terminated before completing accrual due to evolving standards of care. Eighty-three patients were randomized. Median PFS was longer with EP versus irinotecan (4.0 versus 2.8 months, respectively; HR 0.65; 95% CI 0.40-1.04; P = 0.07). Six-month PFS rates were 32.8 and 15.4%, respectively. Median OS was 9.6 and 8.4 months in EP and irinotecan arms, respectively (HR 0.91; 95% CI 0.56-1.49). ORRs were 10 and 5%, respectively (P = 0.676); median DOR was significantly longer in EP arm (7.9 versus 1.4 months; P = 0.018). The most common grade-3/4 adverse events for EP and irinotecan were diarrhea (21 vs 20%), neutropenia (10 vs 22%), abdominal pain (14 vs 5%), nausea (14 vs 2%), and vomiting (12 vs 7%), respectively.

Conclusion: EP is active and safe for second-line treatment of KRAS-mutant, irinotecan-naïve mCRC.

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