CRYSTAL & FIRE-3
The trials that established EGFR antibodies in bowel cancer and discovered they only work when the RAS gene is normal.
CRYSTAL (NEJM 2009) showed cetuximab + FOLFIRI improved PFS and, in KRAS wild-type tumours, OS (23.5 vs 20.0 months). Retrospective RAS analyses defined the first negative predictive biomarker in CRC. FIRE-3 (Lancet Oncology 2014) showed longer OS with cetuximab than bevacizumab in KRAS wild-type disease (28.7 vs 25.0 months), later shown to be driven by left-sided tumours.
- Median 23.5 vs 20 months with FOLFIRI + cetuximab compared with FOLFIRI; about 3.5 months longer for half the group.
- A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
- Put another way, the treated group had about 20 percent lower chance of the event at any given time (hazard ratio 0.8).
- Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.
- These results apply to the people the trial enrolled: First-line metastatic colorectal cancer: FOLFIRI ± cetuximab (CRYSTAL); FOLFIRI + cetuximab vs FOLFIRI + bevacizumab (FIRE-3). People in a different situation may not see the same effect.
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.
Pages like this
not linked directly; found by shared links- TrialPARADIGM
Shares Sidedness (left vs right colon), Anti-EGFR antibody + chemotherapy in left-sided RAS/BRAF wild-type mCRC, Bevacizumab, EGFR.
- TrialBREAKWATER
Shares FOLFIRI (5-FU, leucovorin, irinotecan), Cetuximab, EGFR, Colorectal cancer.
- PersonRyan B. Corcoran
Shares Cetuximab, KRAS, EGFR, Colorectal cancer.
- CollectionColorectal Cancer Alliance
Shares Sidedness (left vs right colon), KRAS, Colorectal cancer.
- ProductPanitumumab
Shares Anti-EGFR antibody + chemotherapy in left-sided RAS/BRAF wild-type mCRC, EGFR, Colorectal cancer.
- PersonJosep Tabernero
Shares Cetuximab, EGFR, Colorectal cancer.
- PersonCarsten Bokemeyer
Shares Cetuximab, Colorectal cancer.
- PersonDongsheng Tu
Shares Cetuximab, Colorectal cancer.