Maintenance in colon cancer, bevacizumab and panitumumab regimens – pro
WIth prolonged survivals of metastatic colon patients, maintenance appears to be a useful pardign. Sonbol et al found that Compared with observation, maintenance therapy showed a PFS benefit (hazard ratio, 0.58; 95% CI, 0.43-0.77) but not an OS benefit (hazard ratio, 0.91; 95% CI, 0.83-1.01). All maintenance strategies (FP, FP + Bev, and Bev) showed significant improvement in PFS vs observation. On SUCRA analysis, maintenance treatment (FP or FP + Bev) had the highest likelihood of achieving improved PFS (67.1% for FP, 99.8% for FP + Bev, and 36.5% for Bev) and OS (81.3% for FP, 73.2% for FP + Bev, and 32.6% for Bev)c
However, for maintenance with panitumumab, there is nto sufficient published information to support it. Modest et al concluded: “Maintenance of panitumumab plus 5‐FU/LV after oxaliplatin discontinuation was well tolerated and may be an acceptable treatment paradigm for patients demonstrating a good response to first‐line treatment. Prospective studies are warranted.”.
M.B. Sonbol et al, The Role of Maintenance Strategies in Metastatic Colorectal Cancer
A Systematic Review and Network Meta-analysis of Randomized Clinical Trials. JAMA Oncol. 2020 Mar; 6(3): e194489..
Modest DP, Rivera F, Bachet JB, de Braud F, Pietrantonio F, Koukakis R, Demonty G, Douillard JY. Panitumumab-based maintenance after oxaliplatin discontinuation in metastatic colorectal cancer: A retrospective analysis of two randomised trials. Int J Cancer. 2019 Jul 15;145(2):576-585.