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The oxaliplatin companion to CRYSTAL. It confirmed that the EGFR antibody only works when KRAS is normal.
OPUS randomised 344 patients with EGFR-expressing metastatic colorectal cancer to FOLFOX4 with or without cetuximab. KRAS status was evaluable in 315 of them (93 percent) and 179 (57 percent) were wild-type; 11 of 309 KRAS and BRAF evaluable tumours carried a BRAF mutation, all in the KRAS wild-type group. In KRAS wild-type disease cetuximab improved progression-free survival (hazard ratio 0.567, p=0.0064) and response (odds ratio 2.551, p=0.0027). The trial was too small to judge BRAF. Together with CRYSTAL it made KRAS testing compulsory in 2008 and 2009, the first negative predictive biomarker in solid-tumour oncology.
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.
Shares PARADIGM, CRYSTAL & FIRE-3, RAS wild-type (extended KRAS and NRAS testing), Cetuximab.
Shares Oxaliplatin, Cetuximab, FOLFOX (5-FU, leucovorin, oxaliplatin), EGFR.
Shares Oxaliplatin, Cetuximab, FOLFOX (5-FU, leucovorin, oxaliplatin), EGFR.
Shares PARADIGM, CRYSTAL & FIRE-3, Cetuximab, FOLFOX (5-FU, leucovorin, oxaliplatin).
Shares Oxaliplatin, Cetuximab, FOLFOX (5-FU, leucovorin, oxaliplatin), EGFR.
Shares PARADIGM, BRAF, FOLFOX (5-FU, leucovorin, oxaliplatin), EGFR.
Shares Oxaliplatin, Cetuximab, FOLFOX (5-FU, leucovorin, oxaliplatin), EGFR.
Shares CRYSTAL & FIRE-3, BRAF, Cetuximab, EGFR.