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XELOX placebo N=350. FOLFOX4 placebo N=351. XELOX bevacizumabN=350. FOLFOX4 bevacizumabN=350. XELOX N=317. FOLFOX4 N=317. Initial 2-arm open-label study (N=634). Protocol amended to 2x2 placebo-controlled design after bevacizumab phase III data1 became available (N=1401). Recruitmen
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1. First efficacy and safety results from XELOX-1/NO16966, a randomised 2x2 factorial phase III trial of XELOX vs FOLFOX4 + bevacizumab or placebo in first-line metastatic colorectal cancer
Professor Jim Cassidy
Cancer Research UK Department of Oncology, University of Glasgow
On behalf of the XELOX-1/NO16966 investigators
2. NO16966 study design
3. Study drugs
4. Study objectives Main endpoint = progression-free survival (PFS)
Two primary objectives
XELOX is non-inferior to FOLFOX
Non-inferiority concluded if upper limit of 97.5% CI = 1.23
Bevacizumab + chemotherapy* is superior to placebo + chemotherapy
Superiority concluded if p = 0.025
5. Study populations ITT (intent-to-treat) = all randomised*
used for the bevacizumab superiority analyses
EPP (eligible patient population) = ITT minus major protocol violators and patients not receiving at least one dose of study drug
used for the XELOX non-inferiority analyses due to health authority requirements
Safety population = all patients receiving at least one dose of the respective study drug
6. Baseline characteristics
7. XELOX non-inferiority question
8. PFS XELOX non-inferiority: primary objective met based on ITT
9. PFS XELOX non-inferiority: primary objective met based on EPP
10. PFS non-inferiority subgroup analysis
11. Safety profile: FOLFOX vs XELOX
12. Bevacizumab superiority question
13. PFS chemotherapy + bevacizumab superiority: primary objective met
14. PFS chemotherapy + bevacizumab superiority: XELOX and FOLFOX subgroups
15. PFS superiority subgroup analysis
16. Hypothesis: FOLFOX + placebo patients with prior adjuvant therapy have better baseline prognosis
17. Safety profile: chemotherapy + placebo or bevacizumab
18. Comparison of treatment duration and PFS in AVF2107 vs NO16966
19. Comparison of treatment duration and PFS in AVF2107 vs NO16966
20. ConclusionsXELOX
XELOX is non-inferior to FOLFOX
XELOX and FOLFOX safety profiles are balanced
XELOX offers the advantage of oral fluoropyrimidine administration
XELOX is a good alternative to FOLFOX
21. ConclusionsBevacizumab 1st evidence from 1st line CRC phase III trial that bevacizumab adds
clinically meaningful
statistically superior benefit
to oxaliplatin-based chemotherapy
Safety profile overall in line with previous trial experience in colorectal cancer
The outcome of this trial adds to the large body of evidence supporting the use of bevacizumab in combination with standard 1st line chemotherapy
22. Thank you to…
The patients participating in this trial and their families
The investigators
The study nurses and site coordinators
The study management team at Roche