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Colorectal Cancer – New 1st for Left-Sided RAS-WT

Overview

Colorectal cancer is one of the most common types of malignant tumors in humans. According to statistics, the risk of developing this tumor in a lifetime is:

  • Around 1 in 23 (4.3%) for men
  • Around 1 in 25 (4.0%) for women

Unfortunately, many cases of colorectal cancer are revealed when the cancerous cells have already spread beyond their original location. We call this metastatic cancer.

In this article, we will cover the findings of a phase III clinical study that inspected the effectiveness of Vectibix on left-sided RAS wild type (wt) metastatic colorectal cancer.

What is left-sided RAS wild-type (WT) metastatic colorectal cancer?

RAS is the most common genetic mutation found in patients with colon cancer. Therefore, adding the term ‘RAS’ before a cancer means this specific genetic mutation is present.

Wild-type (WT) RAS means there are no mutations present on the RAS genes.

Therefore, a left-sided RAS wild-type (WT) metastatic colon cancer translates to:

A colorectal cancer that originated in the left side of the colon and spreads beyond original location. No mutations in the RAS genes were identified.

What is Vectibix in colon cancer?

Vectibix is beneficial in treating colorectal cancers that express epidermal growth factor receptors (EGFRs) on the surface of the cells. The indication of using this drug for colorectal cancer is limited to metastatic cases.

The doctor may recommend this treatment for patients who failed to improve after receiving the following chemotherapeutic agents:

How to give Vectibix?

Like many other biological drugs, healthcare professionals administer Vectibix via an intravenous infusion. To deliver this drug, doctors use an infusion pump.

The dosage of Vectibix for the treatment of metastatic colorectal cancer depends on several factors. These include your weight, height, concurrent medical conditions, and general health.

The findings from the PARADIGM study in colon cancer

This clinical trial is called the “PARADIGM trial”. This clinical trial was conducted in Japan, where researchers randomly recruited patients with RAS WT metastatic colorectal cancer. The number of patients mounted to 823 between May 2015 and June 2017. Out of these patients, 12 did not receive the treatment, and 9 were excluded from the study because they lacked some of the inclusion criteria. The vast majority of patients had left-sided colon cancer.

The primary endpoint for this study was Survival. Secondary endpoints included progression-free survival (PFS, the time for the disease to progress under the treatment), Response Rate (RR – percentage of patients whose tumors’ volume decreased by 30-50%), and curative resection (R0) rate.

After randomization, patients were divided into two groups:

After analyzing the results, Vectibix significantly improved Survival compared to Avastin, 37.9 months vs 34.3.

As for PFS, it was comparable between the two groups. Despite that, RR and R0 were much higher in the first group compared to the second one.

These results clearly demonstrate the superiority of Vectibix in treating left-sided RAS-WT metastatic colorectal cancer.

Takeaway message for colon cancer patients

Using Vectibix to treat left-sided RAS-WT metastatic colorectal cancer showed promising results in the PARADIGM clinical trial.

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