Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Metastatic Colorectal Cancer: Combo ‘Promising’ for Overall Survival

Key clinical point: Treatment with avelumab and cetuximab plus oxaliplatin, leucovorin, and 5-fluorouracil failed to meet the primary endpoint for progression-free survival but was associated with “promising” yet “preliminary” overall survival in patients with previously untreated metastatic colorectal cancer.

Major finding: The 12-month progression-free survival was 40%, and the overall survival was 84% at a median follow-up of 16.2 months

Study details: A phase 2 trial of 43 patients with previously untreated metastatic colorectal cancer.

Disclosures: This research was sponsored by AIO-Studien-gGmbH. Dr. Tintelnot disclosed no conflicts of interest.

Citation:

Tintelnot J et al. SITC 2019, Abstract O16.

Commentary:

Immune checkpoint inhibition has been demonstrated to be effective against tumors with high microsatellite instability, regardless of morphology. However, the majority of tumors in patients with metastatic colorectal cancer (MCRC) exhibit microsatellite stability. It has been postulated that select chemotherapeutic agents may enhance the activity of immunotherapy. Binder et al. evaluated whether the addition of the PD-L1 antibody avelumab improved outcomes in patients also receiving 5-fluorouracil, oxaliplatin, and cetuximab. The overall response rate of 79.5% was notable and considerably higher than that previously identified for 5-fluorouracil, oxaliplatin, and cetuximab. Further studies are definitely warranted to verify this encouraging finding.—Mark A. Klein, MD