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The head-to-head test of the two biological drugs given first for bowel cancer. Overall they tied, and only the later analysis by which side of the colon the tumour started separated them.
CALGB/SWOG 80405 randomised 1,137 patients with KRAS wild-type untreated advanced colorectal cancer to cetuximab (578) or bevacizumab (559) with mFOLFOX6 or FOLFIRI chosen by the treating team. Median overall survival was 30.0 against 29.0 months (stratified hazard ratio 0.88, 95% CI 0.77 to 1.01, p=0.08), progression-free survival 10.5 against 10.6 months and response 59.6 against 55.2 percent. The trial therefore did not choose between the classes. Its secondary analyses by primary tumour side, published alongside those of FIRE-3, showed the anti-EGFR advantage is confined to left-sided tumours and that right-sided tumours do worse with cetuximab, the observation PARADIGM later confirmed prospectively.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
1,137 analysed.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Overall survivalprimary | Chemotherapy plus cetuximab | 578 | 30 months | 0.88 (0.77 to 1.01) | 0.08 | link |
| Chemotherapy plus bevacizumab | 559 | 29 months |
Shares Sidedness (left vs right colon), Alliance for Clinical Trials in Oncology, SWOG Cancer Research Network, FOLFIRI (5-FU, leucovorin, irinotecan).
Shares PARADIGM, Sidedness (left vs right colon), FOLFIRI (5-FU, leucovorin, irinotecan), VEGF / VEGFR.
Shares PARADIGM, CRYSTAL & FIRE-3, RAS wild-type (extended KRAS and NRAS testing), Cetuximab.
Shares PARADIGM, CRYSTAL & FIRE-3, RAS wild-type (extended KRAS and NRAS testing), Sidedness (left vs right colon).
Shares CRYSTAL & FIRE-3, Sidedness (left vs right colon), FOLFIRI (5-FU, leucovorin, irinotecan), VEGF / VEGFR.
Shares PARADIGM, CRYSTAL & FIRE-3, Sidedness (left vs right colon), FOLFIRI (5-FU, leucovorin, irinotecan).
Shares FOLFIRI (5-FU, leucovorin, irinotecan), VEGF / VEGFR, FOLFOX (5-FU, leucovorin, oxaliplatin), Anti-angiogenic therapy.
Shares PARADIGM, Sidedness (left vs right colon), VEGF / VEGFR, EGFR.