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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.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\u003EOne of the current standards of care for the first-line therapy of metastatic colorectal cancer (mCRC) is combination chemotherapy with fluoropyrimidine (FP) and oxaliplatin (OX) plus the angiogenesis inhibitor, bevacizumab (BEV). The Phase 3 AIO KRK 0207 study [\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%2F22%2F15.1.atom\u0022\u003ENCT00973609\u003C\/a\u003E] showed that active maintenance therapy with FP+BEV or BEV alone, compared with no treatment, prolonged the time-to-failure of strategy and progression-free survival in patients with mCRC after induction treatment [Arnold D et al. \u003Cem\u003EAnn Oncol\u003C\/em\u003E. 2014 (abstr O-0027); \u003Cem\u003EJ Clin Oncol\u003C\/em\u003E. 2014 (abstr 3503)].\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOncology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EGastrointestinal Cancers\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOncology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EGastrointestinal Cancers\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EOne of the current standards of care for the first-line therapy of metastatic colorectal cancer (mCRC) is combination chemotherapy with fluoropyrimidine (FP) and oxaliplatin (OX) plus the angiogenesis inhibitor, bevacizumab (BEV). However, the optimal duration of the initial induction therapy phase (with the combination regime including all compounds) and the optimal maintenance therapy (MT) have not been defined. The Phase 3 AIO KRK 0207 study [\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%2F22%2F15.1.atom\u0022\u003ENCT00973609\u003C\/a\u003E] showed that active MT with FP+BEV or BEV alone, compared with no treatment, prolonged the time-to-failure of strategy (TFS) and progression-free survival (PFS) in patients with mCRC after induction treatment, according to Dirk Arnold, MD, Klinik f\u00fcr Tumorbiologie, Freiburg, Germany [Arnold D et al. \u003Cem\u003EAnn Oncol.\u003C\/em\u003E 2014 (abstr O-0027); \u003Cem\u003EJ Clin Oncol.\u003C\/em\u003E 2014 (abstr 3503)].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EIn the open-label, prospective AIO KRK 0207 study, 473 patients without disease progression after their 24-week standard induction therapy were randomized to any FP (intravenous or oral) plus BEV (n = 159), BEV monotherapy (n = 156), or no treatment (n = 158). The AIO Study Group-sponsored trial was conducted at 106 sites in Germany to determine whether BEV monotherapy or no treatment was noninferior to FP+BEV.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EFP+BEV is the widely accepted standard for MT [Chibaudel B et al. \u003Cem\u003EJ Clin Oncol.\u003C\/em\u003E 2009; Tournigand C et al. \u003Cem\u003EJ Clin Oncol.\u003C\/em\u003E 2006]. Studies have evaluated whether reducing the intensity of treatment or discontinuing treatment could provide effective MT while improving quality of life for patients through reduced toxicity; however, a clear standard has not been identified [Yalcin S et al. \u003Cem\u003EOncology.\u003C\/em\u003E 2013; Diaz-Rubio E et al. \u003Cem\u003EOncologist.\u003C\/em\u003E 2012].\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe primary end point of TFS, comprising MT with planned re-induction therapy, did not differ between the 3 groups. The median TFS was 6.8, 6.5, and 6.1 months in the FP+BEV, BEV monotherapy, and no-treatment groups. The risk of a shorter TFS was slightly higher in the no-treatment group as compared with the FP+BEV group (HR, 1.22; 95% CI, 0.96 to 1.57; log rank p = .11). The TFS risk was similar for the FP + BEV and BEV monotherapy groups (HR, 0.98; 95% CI, 0.76 to 1.26; Log rank p = .85). However, as the TFS definition included the planned re-induction of the initial treatment, the differences in re-induction therapy (21% of the FP+BEV, 43% BEV monotherapy, 45% no-treatment groups) contributed to this result, stated Dr. Arnold. In general, rates of re-induction therapy were surprisingly low, he stated.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThe secondary end point of time to first progression (PFS1) of disease from MT initiation was longer with FP+BEV (6.2 months) and BEV monotherapy (4.8 months) as compared with no treatment (3.6 months). Compared with no treatment, the risk of disease progression was lower with FP+Bev (HR, 0.49; 95% CI, 0.38 to 0.63) and with BEV monotherapy (HR, 0.64; 95% CI, 0.50 to 0.82).\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThere was no significant difference among the 3 treatment groups for the secondary end point of overall survival (OS) from the start of MT (mean, 23.7 months in all patients; log rank p = .70). This OS was surprisingly long after a (not yet added) 6-month induction treatment phase before randomization, based on the current preliminary data with 200 events, stated Dr. Arnold.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EThe AIO KRK 207 study showed that MT with FP+BEV, BEV monotherapy, or no treatment had a similar effect on the primary end point of TFS in a protocol that included planned re-induction therapy. PFS1 improved with treatment intensity, with FP+BEV yielding better results than BEV alone, and both active MT treatments were better than no treatment. This finding of improved PFS1 confirms the standard of an active MT to exploit the maximum benefit, stated Dr. Arnold.\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\/22\/15.1.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?nzoxu3\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}