Vectibix® is indicated for the treatment of patients with wild-type RAS (defined as wild-type in both KRAS and NRAS as determined by an FDA-approved test for this use) metastatic colorectal cancer (mCRC):Read More
Patients were more likely to have guideline-aligned biomarker testing if they were treated at an academic center2
A retrospective review of the COTA database was performed to identify patients with pathologically confirmed metastatic colon cancer (mCC) diagnosed between January 1, 2013 and December 1, 2017. A total of 1,497 patients with mCC were identified in the observational database. The study included patients with metastatic colon cancer and excluded rectal cancer cases. The COTA database included demographic, diagnostic, treatment, and quality-of-care information for patients with colon cancer abstracted from the electronic health records from 23 practices, including 258 oncologists in Arkansas, Maryland, Michigan, New Jersey, New York, and Tennessee.2
*Defined as wild type in both KRAS and NRAS.3
†Testing for a given biomarker was considered “guideline aligned” if the NCCN guidelines recommended testing for that biomarker for the entire year being analyzed. Guideline-aligned testing in 2013 and 2014 included testing for KRAS by any methodology, in 2015 included extended testing of NRAS and KRAS, and in 2016 and 2017 included extended testing of both KRAS and NRAS, BRAF testing by any methodology, and MSI/dMMR analysis by any methodology.2
COTA = clinically curated EHR data; dMMR = deficient mismatch repair; mCRC = metastatic colorectal cancer; MSI = micro-satellite instability; WT = wild-type.
SYSTEMIC THERAPY FOR mCRC ALGORITHM4
For full treatment guidelines see Morris VK, et al. J Clin Oncol. 2023;41:678-700.
*Defined as wild type in both KRAS and NRAS.3
†Decisions regarding treatment options and sequencing for all patients with mCRC should be made within the context of an MDT.
‡Doublet CT should be offered, or triplet CT may be offered. Shared decision-making is recommended, including a discussion of the potential for benefit and risk of harm; while survival and recurrence outcomes are improved, grade 3 or greater adverse events are more frequent with triplet CT compared to doublet CT.
§Anti-EGFR therapy is not recommended for patients with RAS-mutant mCRC.
**Anti-EGFR therapy is not recommended as a lone biologic agent for treatment-naïve patients with BRAF V600E-mutant mCRC.
††Although anti-EGFR therapy is preferred, anti-VEGF therapy remains an active treatment option for patients with left-sided treatment-naïve RAS wild-type mCRC.
This algorithm is derived from recommendations in Treatment of Metastatic Colorectal Cancer: ASCO Guideline. This is a tool based on an ASCO Guideline and is not intended to substitute for the independent professional judgment of the treating physician. Practice guidelines do not account for individual variation among patients. This tool does not purport to suggest any particular course of medical treatment. Use of the guideline and this tool are voluntary.
ASCO = American Society of Clinical Oncology; CT = chemotherapy; dMMR = deficient mismatch repair; doublet CT = FOLFOX, CAPOX, or FOLFIRI; EGFR = epidermal growth factor receptor; mCRC = metastatic colorectal cancer; MDT = multidisciplinary team; MSI = microsatellite instability; NCCN = National Comprehensive Cancer Network; triplet CT = FOLFOXIRI.
PARADIGM reinforces the value of:
LEARN HOW VECTIBIX® CLINICAL DATA HELPED EVOLVE BIOMARKER-BASED DECISIONS IN PATIENTS WITH mCRC
Drs. Philip and Tauer are paid consultants for Amgen.
*Defined as wild type in both KRAS and NRAS.3
FOLFOX = fluorouracil, leucovorin, and oxaliplatin; OS = overall survival; PARADIGM = Panitumumab and RAS, Diagnostically useful Gene Mutation for metastatic colorectal cancer (mCRC); WT = wild type.
Dermatologic Toxicity: Dermatologic toxicities occurred in 90% of patients and were severe (NCI-CTC grade 3 and higher) in 15% of patients receiving Vectibix® monotherapy [see Dosage and Administration (2.3), Warnings and Precautions (5.1), and Adverse Reactions (6.1)].
Please see Vectibix® full Prescribing Information, including Boxed WARNING.
Vectibix® is indicated for the treatment of patients with wild-type RAS (defined as wild-type in both KRAS and NRAS as determined by an FDA-approved test for this use) metastatic colorectal cancer (mCRC):
Vectibix® is not indicated for the treatment of patients with RAS-mutant mCRC or for whom RAS mutation status is unknown.
Dermatologic Toxicity: Dermatologic toxicities occurred in 90% of patients and were severe (NCI-CTC grade 3 and higher) in 15% of patients receiving Vectibix® monotherapy [see Dosage and Administration (2.3), Warnings and Precautions (5.1), and Adverse Reactions (6.1)].
References 1. Morris VK, Kennedy EB, Baxter NN, et al. J Clin Oncol. 2023;41:678-700. 2. Gutierrez M, Price K, Lanman R, et al. JCO Precis Oncol. 2019;3:PO.19.00274. 3. Vectibix® (panitumumab) prescribing information, Amgen. 4. Systemic therapy for metastatic colorectal cancer (mCRC) algorithm. ASCO Guidelines®. 2022. 5. Watanabe J, Muro K, Shitara K, et al. JAMA. 2023;329:1271-1282.