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Tveit K, Guren T, Glimelius B, Pfeiffer P, Sorbye H, Pyrhonen S, Kure E, Ikdahl T, Skovlund E, Christoffersen T. Randomized phase III study of 5-fluorouracil/folinate/oxaliplatin given continuously or intermittently with or without cetuximab, as first-line treatment of metastatic colorectal cancer: The NORDIC VII study (NCT00145314), by the Nordic Colorectal Cancer Biomodulation Group. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.365] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
365 Background: The role of anti-EGFR therapy in first-line treatment of metastatic colorectal cancer (mCRC) is not established. In the present study pts were randomized to FLOX or FLOX + cetuximab until progression or FLOX intermittently + cetuximab continuously. Methods: Treatment arm A: Nordic FLOX (q2w): oxaliplatin 85 mg/m2day 1, 5-FU bolus 500 mg/m2 and FA 60 mg/m2 day 1-2; B: FLOX + cetuximab, initial dose 400 mg/m2, then 250 mg/m2/week; C: FLOX for 16 weeks + cetuximab continuously, with FLOX added at progression. Primary endpoint was progression-free survival (PFS). Results: Between May 05-Oct 07, 571 pts were randomized, 566 pts evaluable in intention to treat (ITT) analyses. Median age was 61 (24-74). ECOG status: 0=67%, 1=29%, 2=4%. KRAS and BRAF mutation (mut) analyses were obtained in 498 (87%) and 457 pts (81%), respectively. 40% of tumors had KRAS mut, 12% had BRAF mut. Cetuximab combined with Nordic FLOX did not significantly improve RR, PFS or OS compared to FLOX. KRAS mutation was not predictive for cetuximab effect. OS was similar for patients treated with FLOX intermittently and cetuximab continuously as for patients treated until progression. BRAF mutation was a strong negative prognostic factor (median OS 7.6 vs. 20.4 mo). Conclusions: Cetuximab did not add significant benefit to the Nordic FLOX regimen in first-line treatment of mCRC, irrespective of KRAS-mut. [Table: see text] [Table: see text]
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Affiliation(s)
- K. Tveit
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - T. Guren
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - B. Glimelius
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - P. Pfeiffer
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - H. Sorbye
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - S. Pyrhonen
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - E. Kure
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - T. Ikdahl
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - E. Skovlund
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - T. Christoffersen
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
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Ryberg D, Kure E, Lystad S, Skaug V, Stangeland L, Mercy I, Børresen AL, Haugen A. p53 mutations in lung tumors: relationship to putative susceptibility markers for cancer. Cancer Res 1994; 54:1551-5. [PMID: 8137262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We have screened 108 non-small cell lung tumors for mutational alterations in the p53 gene (exons 5 through 8) using polymerase chain reaction and denaturing gel electrophoresis techniques. Thirty-four cases (32%) had aberrant band migrations. The following DNA-sequencing step confirmed the mutations in all these samples. Seventy-six % of the mutations were found at G:C base pairs. Of all the mutations found, 29% were GC to AT, 29% GC to TA, 15% AT to GC, 12% GC to CG, and 3% AT to CG. The other mutations (12%) were deletions or insertions of one base pair. The frequency of p53 mutations among heavy smokers was higher than in nonsmokers (P = 0.047; odds ratio, 6.75; 95% confidence interval, 0.80-57). We examined p53 mutations in relation to genotypes of GSTmu1 and H-ras1. Our data showed that nearly all heavy smokers with transversion mutations were homozygous for the GSTmu1 null allele (10 of 11). The frequency of such mutations was significantly higher for patients with two null alleles (10 of 25) than for those with at least one allele intact (1 of 18) (P = 0.011; odds ratio, 11.33; 95% confidence interval, 1.29-99.3). This study indicated that rare alleles at the variable number of tandem repeats region flanking the H-ras protooncogene are negatively associated to the presence of p53 mutations in the tumors (P = 0.009).
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Affiliation(s)
- D Ryberg
- Department of Toxicology, National Institute of Occupational Health, Oslo, Norway
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