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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe optimal duration of treatment with fluoropyrimidines (FPs), oxaliplatin (OX), and bevacizumab (BEV) for patients with metastatic colorectal cancer (mCRC) is not known. This article presents results from the phase 3 study Optimal Maintenance Therapy With Bevacizumab After Induction in Metastatic Colorectal Cancer (CRC) [AIO KRK 0207; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00973609\u0026amp;atom=%2Fspmdc%2F14%2F36%2F9.atom\u0022\u003ENCT00973609\u003C\/a\u003E]. This trial investigated maintenance chemotherapy with FPs+BEV, BEV alone, or no treatment following a 24-week first-line induction with FPs, OX, and BEV for patients with mCRC.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EGastrointestinal Cancers\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOncology Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EGastrointestinal Cancers\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOncology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOncology Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EThe optimal duration of treatment with fluoropyrimidines (FPs), oxaliplatin (OX), and bevacizumab (BEV) for patients with metastatic colorectal cancer (mCRC) is not known. Susanna Hegewisch-Becker, MD, Onkologische Schwerpunktpraxis Eppendorf, Hamburg, Germany, presented results from the phase 3 study Optimal Maintenance Therapy With Bevacizumab After Induction in Metastatic Colorectal Cancer (CRC) [AIO KRK 0207; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00973609\u0026amp;atom=%2Fspmdc%2F14%2F36%2F9.atom\u0022\u003ENCT00973609\u003C\/a\u003E]. This trial investigated maintenance chemotherapy with FPs + BEV, BEV alone, or no treatment following a 24-week first-line induction with FPs, OX, and BEV for patients with mCRC.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EPatients with at least stable disease (SD) after induction therapy were randomly assigned to FPs (any standard regimen that includes an FP, eg, FOLFOX4) plus BEV (n = 158), BEV alone (n = 156), or no therapy (n = 158). At first progression, patients received reinduction therapy with any FP with or without either BEV or OX until second progression occurred. The primary end point was the time to failure of strategy (TFS), including maintenance plus reinduction after first progression. Secondary end points included time to first progression (PFS-1), overall survival (OS), quality of life (QOL), and biomarker studies.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EAll 3 arms appeared well balanced for baseline characteristics. Median TFS from randomization for all patients was 6.4 months. Median PSF-1 for all patients from randomization was 4.6 months. Updated outcome results are summarized in \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/12109\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/12109\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12109\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-5\u0022 class=\u0022first-child\u0022\u003EUpdated Outcome Results\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EThere was no significant difference in TFS between FPs + BEV and BEV (HR, 1.03; 95% CI, 0.81 to 1.31; \u003Cem\u003EP\u003C\/em\u003E = .82) or between FPs + BEV and no therapy (HR, 1.27; 95% CI, 1.0 to 1.62; \u003Cem\u003EP\u003C\/em\u003E = .054). There was no significant difference in PFS-1 between FPs + BEV and BEV (HR, 1.26; 95% CI, 0.99 to 1.60; \u003Cem\u003EP\u003C\/em\u003E = .061); however, there were significant differences in PFS-1 between FPs + BEV and no therapy (HR, 2.05; 95% CI. 1.61 to 2.63; \u003Cem\u003EP\u003C\/em\u003E \u0026lt; .00001) and BEV versus no therapy (HR, 1.53; 95% CI, 1.21 to 1.93; \u003Cem\u003EP\u003C\/em\u003E = .00039).\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EThere was no significant difference among groups for OS, which may be because not enough events occurred and because of the use of new further-line therapies at progression that became available during the study. Dose reductions or discontinuations of OX during induction did not appear to affect PFS-1 or OS.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EThe best response at induction had a prognostic effect on OS. Median OS was 24 months for patients with complete response or partial response, whereas OS was 19.8 months for patients with SD. There were no differences across treatment arms for OS or PFS-1 when stratified for best response at induction.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EPatients with wild-type tumors treated with BEV had a PFS-1 of 6.8 versus 3.9 months for no therapy (\u003Cem\u003EP\u003C\/em\u003E \u0026lt; .001). For any mutation with a poorer prognosis, there was no significant difference for BEV versus no treatment (4.2 vs 3.6 months, \u003Cem\u003EP\u003C\/em\u003E = .17). Subgroup analysis of OS did not identify patient groups with more or less benefit from FPs + BEV. Results of QOL studies indicated that active treatment did not reduce QOL, and a lack of therapy did not cause fear of progression.\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EThis study confirms the use of active maintenance treatment as standard of care for most patients to improve PFS-1. The lack of a clear OS benefit suggests that an individualized approach to active maintenance therapy may be appropriate.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/36\/9.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzm0k2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzm0k2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}