Amgen Announces Overall Survival Results for Vectibix(R) in First-Line Metastatic Colorectal Cancer
06 November 2009 - 12:03AM
PR Newswire (US)
Phase 3 Results Reinforce Importance of KRAS Status THOUSAND OAKS,
Calif., Nov. 5 /PRNewswire-FirstCall/ -- Amgen (NASDAQ: AMGN) today
announced that the Phase 3 PRIME "203" trial evaluating Vectibix®
(panitumumab) administered in combination with FOLFOX (an
oxaliplatin-based chemotherapy) as a first-line treatment of
metastatic colorectal cancer (mCRC) failed to meet a secondary
endpoint of overall survival. Earlier this year, it was announced
that the trial met its primary endpoint by significantly prolonging
progression-free survival (PFS) in the first-line treatment of
patients with KRAS wild-type mCRC. The prospective analysis of the
203 study showed that Vectibix, when added to a FOLFOX chemotherapy
regimen in patients with KRAS wild-type mCRC, resulted in a median
overall survival of 23.9 months compared to 19.7 months for
patients treated with FOLFOX alone. The median overall survival
difference of 4.2 months in the Vectibix arm did not reach
statistical significance (HR=0.83, p=0.072). "As we previously
announced, the 203 study met its primary endpoint of
progression-free survival in the first-line treatment of patients
with KRAS wild-type metastatic colorectal cancer," said Roger M.
Perlmutter, M.D., Ph.D., executive vice president of Research and
Development at Amgen. "While not statistically significant, we are
also encouraged by the positive trend of the data for overall
survival for these patients treated with Vectibix." Overall
survival appeared to be reduced in patients with KRAS mutant tumors
receiving Vectibix. Although not statistically significant, this
result emphasizes the importance, as described in product labeling,
of ensuring that patients receiving Vectibix do not bear tumors
containing KRAS mutations. Overall, the adverse event profile was
as anticipated for an anti-EGFR antibody in combination with
oxaliplatin-based chemotherapy, including known events such as
rash, diarrhea and hypomagnesemia. Vectibix-related grade 3
infusion reactions were reported for two patients (less than 1
percent). Originally designed to compare the treatment effect in
the overall population, the study was amended to analyze outcomes
with respect to the presence or absence of activating mutations in
KRAS in the tumor itself. Tumor KRAS status was ascertained in more
than 90 percent of the 1,183 patients enrolled in the trial.
Available results from the trial were presented earlier this year
at the 2009 ECCO 15 - ESMO 34 European Multidisciplinary Congress
in Berlin, Germany showing that Vectibix significantly improved
median progression-free survival by 1.6 months (9.6 versus 8.0
months for patients treated with FOLFOX alone, in patients with
KRAS wild-type mCRC (primary endpoint). Further, the addition of
Vectibix to chemotherapy also improved response rate in the KRAS
wild-type patient population as measured by blinded central review
(55 percent versus 48 percent in the FOLFOX only arm). The data for
the 203 study has been submitted for consideration of presentation
at the American Society of Clinical Oncology - The Gastrointestinal
Cancers Symposium Meeting for 2010. Study Design Patients enrolled
in the "203" or PRIME trial (Panitumumab Randomized trial in
combination with chemotherapy for Metastatic colorectal cancer to
determine Efficacy) were randomized to receive either 6.0 mg/kg of
Vectibix and FOLFOX4 once every two weeks (Q2W) or FOLFOX4 alone
Q2W. The primary endpoint of the study is progression-free survival
by KRAS status and secondary endpoints include overall survival,
objective response rate, time to progression, duration of response
and safety. About KRAS Results from studies performed over the last
twenty-five years indicate that KRAS plays an important role in
cell growth regulation. In mCRC, EGFR transmits signals through a
set of intracellular proteins. Upon reaching the nucleus, these
signals instruct the cancer cell to reproduce and metastasize,
leading to cancer progression. Anti-EGFR antibody therapies work by
blocking the activation of EGFR, thereby inhibiting downstream
events that lead to malignant signaling. However, it is
hypothesized that in patients whose tumors harbor a mutated KRAS
gene, the KRAS protein is always turned "on," regardless of whether
the EGFR has been activated or therapeutically inhibited. KRAS
mutations occur in approximately 40 - 50 percent of mCRC. About
Colorectal Cancer Colorectal cancer is the fourth most common
cancer in men and the third most common cancer in women worldwide.
In 2007, approximately 1.2 million cases of colorectal cancer were
expected to occur globally. With more than 630,000 deaths worldwide
per year, it is the second leading cause of cancer-related death in
the Western world. The highest incidence rates are found in Japan,
North America, parts of Europe, New Zealand, and Australia, and
rates are low in Africa and South-East Asia. Rates are
substantially higher in men than in women. About Vectibix Vectibix
is the first fully human anti-EGFR antibody approved by the U.S.
Food and Drug Administration (FDA) for the treatment of mCRC.
Vectibix was approved in the United States in September 2006 as a
monotherapy for the treatment of patients with EGFR expressing mCRC
after disease progression on or following fluoropyrimidine-,
oxaliplatin-, and irinotecan-containing chemotherapy regimens. The
effectiveness of Vectibix as a single agent for the treatment of
EGFR-expressing, metastatic colorectal carcinoma is based on
progression-free survival. Currently no data are available that
demonstrate an improvement in disease-related symptoms or increased
survival with Vectibix. Vectibix has not shown a treatment benefit
for patients whose tumors had KRAS mutations in codon 12 or 13. In
December 2007, the EMEA granted a conditional marketing
authorization for Vectibix as monotherapy for the treatment of
patients with EGFR-expressing mCRC with wild-type KRAS genes after
failure of standard chemotherapy regimens. Vectibix has been
launched in over 20 countries, Switzerland, Australia and Canada.
Applications in the rest of the world are pending. Important
Product Safety Information Dermatologic Toxicity: Dermatologic
toxicities occurred in 89 percent of patients and were severe
(NCI-CTC grade 3 and higher) in 12 percent of patients receiving
Vectibix monotherapy. Withhold Vectibix for dermatologic toxicities
that are grade 3 or higher or are considered intolerable. If
toxicity does not improve to