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Erschienen in: Targeted Oncology 3/2019

15.06.2019 | Original Research Article

MINOAS: A Single-arm Translational Phase II Trial of FOLFIRI Plus Aflibercept as First-line Therapy in Unresectable, Metastatic Colorectal Cancer

verfasst von: Alexios Matikas, John Souglakos, Panagiotis Katsaounis, Athanasios Kotsakis, Panagiotis Kouroupakis, Nikolaos Pantazopoulos, Nikolaos Kentepozidis, Adamantia Nikolaidi, Ippokratis Messaritakis, Ioanna Tzovara, Dora Hatzidaki, Efthymis Prinarakis, Vassilis Georgoulias

Erschienen in: Targeted Oncology | Ausgabe 3/2019

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Abstract

Background

FOLFIRI/aflibercept is approved as a second-line treatment in metastatic colorectal cancer (mCRC) but there are limited data for its use as a first-line treatment.

Objective

To investigate the activity and safety of first-line FOLFIRI/aflibercept in mCRC, as well as to prospectively evaluate biomarkers of early response to treatment.

Patients and methods

MINOAS was a phase II trial that aimed to evaluate the activity and toxicity of first-line FOLFIRI/aflibercept in mCRC. The primary endpoint was objective response rate (ORR). The secondary endpoints were toxicity, progression-free survival (PFS), overall survival (OS), and the evaluation of CEACAM-positive circulating tumor cells (CTC) and diffusion-weighted (DW)-MRI as biomarkers.

Results

Thirty-one patients were enrolled and 259 chemotherapy cycles were administered. At the time of the preplanned interim analysis, all patients had discontinued treatment and the ORR was 61.3%, crossing the activity threshold for trial discontinuation. Median PFS was 8.4 months (95% CI 7.8–9.0). Median OS had not been reached. There was one toxic death due to sepsis; grade 3/4 adverse events included neutropenia (n = 5), diarrhea (n = 6), hypertension (n = 4), asthenia (n = 3), proteinuria (n = 1), and bowel perforation (n = 1). Retaining CTC-negative status predicted better OS compared to continuous detection of CTCs (p = 0.015). Early decrease of the apparent diffusion coefficient (ADC) in DW-MRI was associated with an objective response.

Conclusion

The activity and safety of first-line FOLFIRI/aflibercept merit further evaluation in randomized studies.

Clinicaltrials.gov registration number

NCT02624726.
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Metadaten
Titel
MINOAS: A Single-arm Translational Phase II Trial of FOLFIRI Plus Aflibercept as First-line Therapy in Unresectable, Metastatic Colorectal Cancer
verfasst von
Alexios Matikas
John Souglakos
Panagiotis Katsaounis
Athanasios Kotsakis
Panagiotis Kouroupakis
Nikolaos Pantazopoulos
Nikolaos Kentepozidis
Adamantia Nikolaidi
Ippokratis Messaritakis
Ioanna Tzovara
Dora Hatzidaki
Efthymis Prinarakis
Vassilis Georgoulias
Publikationsdatum
15.06.2019
Verlag
Springer International Publishing
Erschienen in
Targeted Oncology / Ausgabe 3/2019
Print ISSN: 1776-2596
Elektronische ISSN: 1776-260X
DOI
https://doi.org/10.1007/s11523-019-00647-3

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