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    Clinical Trial Results:
    An Open label Randomized Multi-Centre Exploratory Phase II Study to Evaluate the Efficacy and Safety of the Combination of Panitumumab with FOLFOX 4 Chemotherapy or Panitumumab with FOLFIRI Chemotherapy in Subjects with Wild-Type KRAS Colorectal Cancer and Liver-only Metastases

    Summary
    EudraCT number
    2008-006766-28
    Trial protocol
    ES  
    Global end of trial date
    31 Mar 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    14 Dec 2018
    First version publication date
    14 Dec 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    TTD-08-04
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00885885
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Spanish Cooperative Group for the Treatment of Digestive Tumors (TTD)
    Sponsor organisation address
    Téllez 30, Madrid, Spain, 28007
    Public contact
    Inmaculada Ruiz Mena, Spanish Cooperative Group for the Treatment of Digestive Tumors (TTD), 0034 913788275, ttd@ttdgroup.org
    Scientific contact
    Inmaculada Ruiz Mena, Spanish Cooperative Group for the Treatment of Digestive Tumors (TTD), 0034 913788275, ttd@ttdgroup.org
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    26 May 2015
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    26 Nov 2013
    Global end of trial reached?
    Yes
    Global end of trial date
    31 Mar 2015
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To compare the objective response rate (ORR) over the entire treatment period when panitumumab was administered in combination with either FOLFOX 4 or FOLFIRI chemotherapy as 1st line treatment in subjects with previously untreated KRAS Wild-Type colorectal cancer (mCRC) and liver-only metastases. To determine the optimal combination (panitumumab + FOLFOX 4 chemotherapy or panitumumab + FOLFIRI chemotherapy) based on efficacy and tolerability for further clinical trials in this population.
    Protection of trial subjects
    Treatment dose was adjusted in terms of adverse events. G-CSF as prophylaxis was not recommended; G-CSF could be used therapeutically at the Investigator’s discretion in patients with serious neutropenic complications. The use of topical, oral, and intravenous antibiotics to treat skin- and nail-related toxicities was allowed at the Investigator’s discretion.
    Background therapy
    None.
    Evidence for comparator
    While there have been few prospective studies of systemic chemotherapy in patients with non-resectable hepatic metastases, it seems clear that the use of FOLFOX and FOLFIRI combination chemotherapy regimens with biological therapies, especially EGFR inhibitors, can increase the response rate
    Actual start date of recruitment
    14 May 2009
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Spain: 80
    Worldwide total number of subjects
    80
    EEA total number of subjects
    80
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    45
    From 65 to 84 years
    35
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    80 patients were included; 3 of them did not receive any study treatment. The safety population included 38 patients in the Panitumumab + FOLFOX-4 arm and 39 patients in the Panitumumab + FOLFIRI arm. This was a national study with all patients being included at 15 Spanish sites

    Pre-assignment
    Screening details
    Key inclusion criteria: Male or female > 18 years of age, histologically confirmed adenocarcinoma of the colon or rectum with liver-only metastases, no major contraindication to liver surgery, wild-type KRAS. 103 patients were assessed for eligibility, of whom 21 did not meet all the inclusion criteria and 2 met one of the exclusion criteria.

    Period 1
    Period 1 title
    Baseline
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded
    Blinding implementation details
    Not applicable.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Panitumumab + FOLFOX 4
    Arm description
    Panitumumab was administered by intravenous infusion on day 1 of each cycle, just prior to administration of chemotherapy. A treatment cycle was defined as the 14 day period following treatment with panitumumab and commencement of FOLFOX 4 chemotherapy. FOLFOX 4 was administered every 2 weeks (± 3 days) as follows: Day 1: Oxaliplatin (85 mg/m2, intravenous infusion) and folinic acid (200 mg/m2, intravenous infusion), both given over 120 minutes (± 15 minutes) at the same time; followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2, intravenous infusion), given as a 22 hour (± 1 hour) continuous infusion. Day 2: Folinic acid (200 mg/m2, intravenous infusion), given over 120 minutes (± 15 minutes); followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2 intravenous infusion), given as a 22 hour (± 1 hour) continuous infusion.
    Arm type
    Experimental

    Investigational medicinal product name
    Panitumumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    The starting panitumumab dose was 6 mg/kg. The panitumumab dose was calculated based on the subject’s body weight at baseline (i.e. Cycle 1) and was not re-calculated unless the actual body weight changed by at least 10% relative to baseline. Panitumumab was diluted in 100 mL of pyrogen-free 0.9% sodium chloride solution. The maximum concentration of the diluted solution to be infused was not to exceed 10 mg/mL; if necessary, the volume of normal saline could be increased. Panitumumab was administered intravenously using an infusion pump.

    Investigational medicinal product name
    FOLFOX 4
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion, Injection
    Routes of administration
    Intravenous use, Intravenous bolus use
    Dosage and administration details
    FOLFOX 4 was administered as follows: Day 1: Oxaliplatin (85 mg/m2, intravenous infusion) and folinic acid (200 mg/m2, intravenous infusion), both given over 120 minutes (± 15 minutes) at the same time; followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2, intravenous infusion), given as a 22 hour (± 1 hour) continuous infusion. Day 2: Folinic acid (200 mg/m2, intravenous infusion), given over 120 minutes (± 15 minutes); followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2 intravenous infusion), given as a 22-hour (± 1 hour) continuous infusion.

    Arm title
    Panitumumab + FOLFIRI
    Arm description
    Panitumumab was administered by intravenous infusion on day 1 of each cycle, just prior to administration of chemotherapy. A treatment cycle was defined as the 14 day period following treatment with panitumumab and FOLFIRI chemotherapy. FOLFIRI was administered every 2 weeks (± 3 days), on day 1 of each cycle, as follows: Irinotecan (180 mg/m2, intravenous infusion) was administered over 90 minutes (± 15 minutes). Folinic acid (400 mg/m2, intravenous infusion) was administered over 2 hours (± 15 minutes) during Irinotecan infusion, but without mixing. Immediately afterwards, a 5-FU intravenous bolus (400 mg/m2) was administered and a 5-FU intravenous infusion (2400 mg/m2) was given as a 46 hour (± 2-hour) continuous infusion.
    Arm type
    Experimental

    Investigational medicinal product name
    Panitumumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    The starting panitumumab dose was 6 mg/kg. The panitumumab dose was calculated based on the subject’s body weight at baseline (i.e. Cycle 1) and was not re-calculated unless the actual body weight changed by at least 10% relative to baseline. Panitumumab was diluted in 100 mL of pyrogen-free 0.9% sodium chloride solution. The maximum concentration of the diluted solution to be infused was not to exceed 10 mg/mL; if necessary, the volume of normal saline could be increased. Panitumumab was administered intravenously using an infusion pump.

    Investigational medicinal product name
    FOLFIRI
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion, Injection
    Routes of administration
    Intravenous bolus use , Intravenous use
    Dosage and administration details
    FOLFIRI was administered on day 1 of each cycle as follows: Irinotecan (180 mg/m2, intravenous infusion) was administered over 90 minutes ± 15 minutes. Folinic acid (400 mg/m2, intravenous infusion) was administered over 2 hours ± 15 minutes during irinotecan infusion. but without mixing. Immediately afterwards, a 5-FU intravenous bolus (400 mg/m2) was administered and a 5-FU intravenous infusion (2400 mg/m2) was given as 46-hour ± 2-hour continuous infusion.

    Number of subjects in period 1 [1]
    Panitumumab + FOLFOX 4 Panitumumab + FOLFIRI
    Started
    38
    39
    Completed
    38
    39
    Notes
    [1] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: 3 patients in Panitumumab + FOLFIRI arm were withdrawn from the study without receiving study treatment: 1 patient had divergent KRAS results and 2 patients had metastases in locations other than the liver. These 3 patients are not included in the presentations of Subject disposition, Baseline characteristics, End points and Adverse events.
    Period 2
    Period 2 title
    Treatment period
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded
    Blinding implementation details
    Not applicable.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Panitumumab + FOLFOX 4
    Arm description
    Panitumumab was administered by intravenous infusion on day 1 of each cycle, just prior to administration of chemotherapy. A treatment cycle was defined as the 14 day period following treatment with panitumumab and commencement of FOLFOX 4 chemotherapy. FOLFOX 4 was administered every 2 weeks (± 3 days) as follows: Day 1: Oxaliplatin (85 mg/m2, intravenous infusion) and folinic acid (200 mg/m2, intravenous infusion), both given over 120 minutes (± 15 minutes) at the same time; followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2, intravenous infusion), given as a 22 hour (± 1 hour) continuous infusion. Day 2: Folinic acid (200 mg/m2, intravenous infusion), given over 120 minutes (± 15 minutes); followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2 intravenous infusion), given as a 22-hour (± 1 hour) continuous infusion.
    Arm type
    Experimental

    Investigational medicinal product name
    Panitumumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    The starting panitumumab dose was 6 mg/kg. The panitumumab dose was calculated based on the subject’s body weight at baseline (i.e. Cycle 1) and was not re-calculated unless the actual body weight changed by at least 10% relative to baseline. Panitumumab was diluted in 100 mL of pyrogen-free 0.9% sodium chloride solution. The maximum concentration of the diluted solution to be infused was not to exceed 10 mg/mL; if necessary, the volume of normal saline could be increased. Panitumumab was administered intravenously using an infusion pump.

    Investigational medicinal product name
    FOLFOX 4
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion, Injection
    Routes of administration
    Intravenous use, Intravenous bolus use
    Dosage and administration details
    FOLFOX 4 was administered as follows: Day 1: Oxaliplatin (85 mg/m2, intravenous infusion) and folinic acid (200 mg/m2, intravenous infusion), both given over 120 minutes (± 15 minutes) at the same time; followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2, intravenous infusion), given as a 22 hour (± 1 hour) continuous infusion. Day 2: Folinic acid (200 mg/m2, intravenous infusion), given over 120 minutes (± 15 minutes); followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2 intravenous infusion), given as a 22-hour (± 1 hour) continuous infusion.

    Arm title
    Panitumumab + FOLFIRI
    Arm description
    Panitumumab was administered by intravenous infusion on day 1 of each cycle, just prior to administration of chemotherapy. A treatment cycle was defined as the 14 day period following treatment with panitumumab and FOLFIRI chemotherapy. FOLFIRI was administered every 2 weeks (± 3 days), on day 1 of each cycle, as follows: Irinotecan (180 mg/m2, intravenous infusion) was administered over 90 minutes ± 15 minutes. Folinic acid (400 mg/m2, intravenous infusion) was administered over 2 hours ± 15 minutes during irinotecan infusion. but without mixing. Immediately afterwards, a 5-FU intravenous bolus (400 mg/m2) was administered and a 5-FU intravenous infusion (2400 mg/m2) was given as 46-hour ± 2 hour continuous infusion.
    Arm type
    Experimental

    Investigational medicinal product name
    Panitumumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    The starting panitumumab dose was 6 mg/kg. The panitumumab dose was calculated based on the subject’s body weight at baseline (i.e. Cycle 1) and was not re-calculated unless the actual body weight changed by at least 10% relative to baseline. Panitumumab was diluted in 100 mL of pyrogen-free 0.9% sodium chloride solution. The maximum concentration of the diluted solution to be infused was not to exceed 10 mg/mL; if necessary, the volume of normal saline could be increased. Panitumumab was administered intravenously using an infusion pump.

    Investigational medicinal product name
    FOLFIRI
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion, Injection
    Routes of administration
    Intravenous bolus use , Intravenous use
    Dosage and administration details
    FOLFIRI was administered on day 1 of each cycle as follows: Irinotecan (180 mg/m2, intravenous infusion) was administered over 90 minutes ± 15 minutes. Folinic acid (400 mg/m2, intravenous infusion) was administered over 2 hours ± 15 minutes during irinotecan infusion. but without mixing. Immediately afterwards, a 5-FU intravenous bolus (400 mg/m2) was administered and a 5-FU intravenous infusion (2400 mg/m2) was given as 46-hour ± 2-hour continuous infusion.

    Number of subjects in period 2
    Panitumumab + FOLFOX 4 Panitumumab + FOLFIRI
    Started
    38
    39
    Completed
    10
    10
    Not completed
    28
    29
         Physician decision
    3
    9
         Disease progression
    13
    11
         Other
    3
    4
         Death
    -
    2
         Adverse event
    1
    1
         Unacceptable toxicity
    7
    2
         Protocol deviation
    1
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Panitumumab + FOLFOX 4
    Reporting group description
    Panitumumab was administered by intravenous infusion on day 1 of each cycle, just prior to administration of chemotherapy. A treatment cycle was defined as the 14 day period following treatment with panitumumab and commencement of FOLFOX 4 chemotherapy. FOLFOX 4 was administered every 2 weeks (± 3 days) as follows: Day 1: Oxaliplatin (85 mg/m2, intravenous infusion) and folinic acid (200 mg/m2, intravenous infusion), both given over 120 minutes (± 15 minutes) at the same time; followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2, intravenous infusion), given as a 22 hour (± 1 hour) continuous infusion. Day 2: Folinic acid (200 mg/m2, intravenous infusion), given over 120 minutes (± 15 minutes); followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2 intravenous infusion), given as a 22 hour (± 1 hour) continuous infusion.

    Reporting group title
    Panitumumab + FOLFIRI
    Reporting group description
    Panitumumab was administered by intravenous infusion on day 1 of each cycle, just prior to administration of chemotherapy. A treatment cycle was defined as the 14 day period following treatment with panitumumab and FOLFIRI chemotherapy. FOLFIRI was administered every 2 weeks (± 3 days), on day 1 of each cycle, as follows: Irinotecan (180 mg/m2, intravenous infusion) was administered over 90 minutes (± 15 minutes). Folinic acid (400 mg/m2, intravenous infusion) was administered over 2 hours (± 15 minutes) during Irinotecan infusion, but without mixing. Immediately afterwards, a 5-FU intravenous bolus (400 mg/m2) was administered and a 5-FU intravenous infusion (2400 mg/m2) was given as a 46 hour (± 2-hour) continuous infusion.

    Reporting group values
    Panitumumab + FOLFOX 4 Panitumumab + FOLFIRI Total
    Number of subjects
    38 39 77
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
        Newborns (0-27 days)
    0
        Infants and toddlers (28 days-23 months)
    0
        Children (2-11 years)
    0
        Adolescents (12-17 years)
    0
        Adults (18-64 years)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        median (inter-quartile range (Q1-Q3))
    65.2 (57.9 to 70.1) 62.6 (51.9 to 67.4) -
    Gender categorical
    Units: Subjects
        Female
    7 11 18
        Male
    31 28 59

    End points

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    End points reporting groups
    Reporting group title
    Panitumumab + FOLFOX 4
    Reporting group description
    Panitumumab was administered by intravenous infusion on day 1 of each cycle, just prior to administration of chemotherapy. A treatment cycle was defined as the 14 day period following treatment with panitumumab and commencement of FOLFOX 4 chemotherapy. FOLFOX 4 was administered every 2 weeks (± 3 days) as follows: Day 1: Oxaliplatin (85 mg/m2, intravenous infusion) and folinic acid (200 mg/m2, intravenous infusion), both given over 120 minutes (± 15 minutes) at the same time; followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2, intravenous infusion), given as a 22 hour (± 1 hour) continuous infusion. Day 2: Folinic acid (200 mg/m2, intravenous infusion), given over 120 minutes (± 15 minutes); followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2 intravenous infusion), given as a 22 hour (± 1 hour) continuous infusion.

    Reporting group title
    Panitumumab + FOLFIRI
    Reporting group description
    Panitumumab was administered by intravenous infusion on day 1 of each cycle, just prior to administration of chemotherapy. A treatment cycle was defined as the 14 day period following treatment with panitumumab and FOLFIRI chemotherapy. FOLFIRI was administered every 2 weeks (± 3 days), on day 1 of each cycle, as follows: Irinotecan (180 mg/m2, intravenous infusion) was administered over 90 minutes (± 15 minutes). Folinic acid (400 mg/m2, intravenous infusion) was administered over 2 hours (± 15 minutes) during Irinotecan infusion, but without mixing. Immediately afterwards, a 5-FU intravenous bolus (400 mg/m2) was administered and a 5-FU intravenous infusion (2400 mg/m2) was given as a 46 hour (± 2-hour) continuous infusion.
    Reporting group title
    Panitumumab + FOLFOX 4
    Reporting group description
    Panitumumab was administered by intravenous infusion on day 1 of each cycle, just prior to administration of chemotherapy. A treatment cycle was defined as the 14 day period following treatment with panitumumab and commencement of FOLFOX 4 chemotherapy. FOLFOX 4 was administered every 2 weeks (± 3 days) as follows: Day 1: Oxaliplatin (85 mg/m2, intravenous infusion) and folinic acid (200 mg/m2, intravenous infusion), both given over 120 minutes (± 15 minutes) at the same time; followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2, intravenous infusion), given as a 22 hour (± 1 hour) continuous infusion. Day 2: Folinic acid (200 mg/m2, intravenous infusion), given over 120 minutes (± 15 minutes); followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2 intravenous infusion), given as a 22-hour (± 1 hour) continuous infusion.

    Reporting group title
    Panitumumab + FOLFIRI
    Reporting group description
    Panitumumab was administered by intravenous infusion on day 1 of each cycle, just prior to administration of chemotherapy. A treatment cycle was defined as the 14 day period following treatment with panitumumab and FOLFIRI chemotherapy. FOLFIRI was administered every 2 weeks (± 3 days), on day 1 of each cycle, as follows: Irinotecan (180 mg/m2, intravenous infusion) was administered over 90 minutes ± 15 minutes. Folinic acid (400 mg/m2, intravenous infusion) was administered over 2 hours ± 15 minutes during irinotecan infusion. but without mixing. Immediately afterwards, a 5-FU intravenous bolus (400 mg/m2) was administered and a 5-FU intravenous infusion (2400 mg/m2) was given as 46-hour ± 2 hour continuous infusion.

    Subject analysis set title
    Panitumumab + FOLFOX 4 (Safety Set)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All randomized subjects in the Panitumumab + FOLFOX 4 arm who received at least one dose of Panitumumab or FOLFOX 4 chemotherapy.

    Subject analysis set title
    Panitumumab + FOLFIRI (Safety Set)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All randomized subjects in the Panitumumab + FOLFIRI arm who received at least one dose of Panitumumab or FOLFIRI chemotherapy.

    Subject analysis set title
    Panitumumab + FOLFOX 4 (WT RAS Set)
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Subjects in the Panitumumab + FOLFOX 4 (Safety Set) analysis set whose RAS mutational status was evaluated and was found to be wild type.

    Subject analysis set title
    Panitumumab + FOLFIRI (WT RAS Set)
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Subjects in the Panitumumab + FOLFIRI (Safety Set) analysis set whose RAS mutational status was evaluated and was found to be wild type.

    Subject analysis set title
    All subjects (Safety Set)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All randomized subjects who received at least one dose of Panitumumab or FOLFOX 4 chemotherapy or FOLFIRI chemotherapy.

    Subject analysis set title
    All subjects (WT RAS Set)
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Subjects in the All patients (Safety Set) analysis set whose RAS mutational status was evaluated and was found to be wild type.

    Primary: Overall response rate

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    End point title
    Overall response rate
    End point description
    Complete response or partial response (modified RECIST)
    End point type
    Primary
    End point timeframe
    From treatment start to the decision to end both treatments (Panitumumab and chemotherapy).
    End point values
    Panitumumab + FOLFOX 4 (Safety Set) Panitumumab + FOLFIRI (Safety Set) Panitumumab + FOLFOX 4 (WT RAS Set) Panitumumab + FOLFIRI (WT RAS Set)
    Number of subjects analysed
    38
    39
    27
    26
    Units: percent
    number (confidence interval 95%)
        ORR (%)
    74 (60 to 88)
    67 (52 to 81)
    78 (62 to 93)
    73 (56 to 90)
    Statistical analysis title
    Chi-square test
    Comparison groups
    Panitumumab + FOLFIRI (Safety Set) v Panitumumab + FOLFOX 4 (Safety Set)
    Number of subjects included in analysis
    77
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.5012
    Method
    Chi-squared
    Confidence interval
    Statistical analysis title
    Chi-square test
    Comparison groups
    Panitumumab + FOLFOX 4 (WT RAS Set) v Panitumumab + FOLFIRI (WT RAS Set)
    Number of subjects included in analysis
    53
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.6909
    Method
    Chi-squared
    Confidence interval

    Secondary: Hepatic resection rate

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    End point title
    Hepatic resection rate
    End point description
    Proportion of subjects with R0 (with tumour free margins and without evidence of microscopic and macroscopic residual disease) and R1 (microscopic residual margin) resections
    End point type
    Secondary
    End point timeframe
    From treatment start to the decision to end both treatments (Panitumumab and chemotherapy).
    End point values
    Panitumumab + FOLFOX 4 (Safety Set) Panitumumab + FOLFIRI (Safety Set) Panitumumab + FOLFOX 4 (WT RAS Set) Panitumumab + FOLFIRI (WT RAS Set)
    Number of subjects analysed
    38
    38
    27
    26
    Units: percent
    number (confidence interval 95%)
        Rate (%)
    34 (19 to 49)
    46 (31 to 62)
    26 (9 to 42)
    54 (35 to 73)
    Statistical analysis title
    Fisher's exact test
    Comparison groups
    Panitumumab + FOLFOX 4 (Safety Set) v Panitumumab + FOLFIRI (Safety Set)
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.2853
    Method
    Fisher exact
    Confidence interval
    Statistical analysis title
    Fisher's exact test
    Comparison groups
    Panitumumab + FOLFOX 4 (WT RAS Set) v Panitumumab + FOLFIRI (WT RAS Set)
    Number of subjects included in analysis
    53
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.0378
    Method
    Fisher exact
    Confidence interval

    Secondary: Time to resection

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    End point title
    Time to resection
    End point description
    Time to surgical resection in subjects who underwent metastatic surgery.
    End point type
    Secondary
    End point timeframe
    From enrolment to the date of surgical resection.
    End point values
    Panitumumab + FOLFOX 4 (Safety Set) Panitumumab + FOLFIRI (Safety Set) Panitumumab + FOLFOX 4 (WT RAS Set) Panitumumab + FOLFIRI (WT RAS Set)
    Number of subjects analysed
    17
    23
    10
    18
    Units: months
        arithmetic mean (standard deviation)
    5.0 ± 2.0
    5.5 ± 2.3
    5.4 ± 2.3
    5.5 ± 2.4
    Statistical analysis title
    Log-rank test
    Comparison groups
    Panitumumab + FOLFOX 4 (Safety Set) v Panitumumab + FOLFIRI (Safety Set)
    Number of subjects included in analysis
    40
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.2832
    Method
    Logrank
    Confidence interval

    Secondary: Duration of response

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    End point title
    Duration of response
    End point description
    End point type
    Secondary
    End point timeframe
    From first confirmed response to first observed disease progression or death (whichever came first).
    End point values
    Panitumumab + FOLFOX 4 (Safety Set) Panitumumab + FOLFIRI (Safety Set)
    Number of subjects analysed
    15
    14
    Units: months
        median (inter-quartile range (Q1-Q3))
    11 (5 to 22)
    11 (6 to 16)
    Statistical analysis title
    Log-rank test
    Comparison groups
    Panitumumab + FOLFOX 4 (Safety Set) v Panitumumab + FOLFIRI (Safety Set)
    Number of subjects included in analysis
    29
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.7588
    Method
    Logrank
    Confidence interval

    Secondary: Time to response

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    End point title
    Time to response
    End point description
    For subjects with a best response of stable disease, the date of their last evaluable radiographic assessment was recorded. For subjects with a best response of progressive disease, the date of their last evaluation was recorded.
    End point type
    Secondary
    End point timeframe
    From treatment start to first confirmed complete response or partial response.
    End point values
    Panitumumab + FOLFOX 4 (Safety Set) Panitumumab + FOLFIRI (Safety Set) Panitumumab + FOLFOX 4 (WT RAS Set) Panitumumab + FOLFIRI (WT RAS Set)
    Number of subjects analysed
    37
    36
    27
    26
    Units: months
        arithmetic mean (standard error)
    5.5 ± 0.3
    5.5 ± 0.6
    5.9 ± 0.3
    5.5 ± 0.3
    Statistical analysis title
    Log-rank test
    Comparison groups
    Panitumumab + FOLFOX 4 (Safety Set) v Panitumumab + FOLFIRI (Safety Set)
    Number of subjects included in analysis
    73
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.842
    Method
    Logrank
    Confidence interval
    Statistical analysis title
    Log-rank test
    Comparison groups
    Panitumumab + FOLFOX 4 (WT RAS Set) v Panitumumab + FOLFIRI (WT RAS Set)
    Number of subjects included in analysis
    53
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.9926
    Method
    Logrank
    Confidence interval

    Secondary: Time to treatment failure

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    End point title
    Time to treatment failure
    End point description
    End point type
    Secondary
    End point timeframe
    From enrolment to treatment failure.
    End point values
    Panitumumab + FOLFOX 4 (Safety Set) Panitumumab + FOLFIRI (Safety Set)
    Number of subjects analysed
    38
    39
    Units: months
        median (confidence interval 95%)
    9 (5 to 11)
    6 (5 to 15)
    Statistical analysis title
    Log-rank test
    Comparison groups
    Panitumumab + FOLFOX 4 (Safety Set) v Panitumumab + FOLFIRI (Safety Set)
    Number of subjects included in analysis
    77
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.7027
    Method
    Logrank
    Confidence interval

    Secondary: Progression-free survival

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    End point title
    Progression-free survival
    End point description
    End point type
    Secondary
    End point timeframe
    From treatment start to first observed disease progression or death (whichever came first).
    End point values
    Panitumumab + FOLFOX 4 (Safety Set) Panitumumab + FOLFIRI (Safety Set) Panitumumab + FOLFOX 4 (WT RAS Set) Panitumumab + FOLFIRI (WT RAS Set)
    Number of subjects analysed
    38
    39
    27
    26
    Units: months
        median (confidence interval 95%)
    13 (6 to 15)
    14 (7 to 16)
    13 (6 to 19)
    15 (7 to 19)
    Statistical analysis title
    Log-rank test
    Comparison groups
    Panitumumab + FOLFOX 4 (Safety Set) v Panitumumab + FOLFIRI (Safety Set)
    Number of subjects included in analysis
    77
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.7297
    Method
    Logrank
    Confidence interval
    Statistical analysis title
    Log-rank test
    Comparison groups
    Panitumumab + FOLFOX 4 (WT RAS Set) v Panitumumab + FOLFIRI (WT RAS Set)
    Number of subjects included in analysis
    53
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.3047
    Method
    Logrank
    Confidence interval

    Secondary: Overall survival

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    End point title
    Overall survival
    End point description
    End point type
    Secondary
    End point timeframe
    From treatment start to death.
    End point values
    Panitumumab + FOLFOX 4 (Safety Set) Panitumumab + FOLFIRI (Safety Set) Panitumumab + FOLFOX 4 (WT RAS Set) Panitumumab + FOLFIRI (WT RAS Set)
    Number of subjects analysed
    38
    39
    27
    26
    Units: months
        median (confidence interval 95%)
    37 (25 to 51)
    41 (22 to 52)
    39 (27 to 51)
    49 (31 to 56)
    Statistical analysis title
    Log-rank test
    Comparison groups
    Panitumumab + FOLFOX 4 (Safety Set) v Panitumumab + FOLFIRI (Safety Set)
    Number of subjects included in analysis
    77
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.9657
    Method
    Logrank
    Confidence interval
    Statistical analysis title
    Log-rank test
    Comparison groups
    Panitumumab + FOLFOX 4 (WT RAS Set) v Panitumumab + FOLFIRI (WT RAS Set)
    Number of subjects included in analysis
    53
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.8237
    Method
    Logrank
    Confidence interval

    Secondary: Depth of response

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    End point title
    Depth of response
    End point description
    Maximum tumour size decrease (%) with respect to baseline measurements (sum of lesion diameters) during treatment, prior to hepatic surgery.
    End point type
    Secondary
    End point timeframe
    From treatment start to hepatic surgery.
    End point values
    Panitumumab + FOLFOX 4 (WT RAS Set) Panitumumab + FOLFIRI (WT RAS Set) All subjects (Safety Set) All subjects (WT RAS Set)
    Number of subjects analysed
    27
    24
    73
    51
    Units: percent
        median (inter-quartile range (Q1-Q3))
    47 (32 to 71)
    48 (42 to 64)
    47 (32 to 60)
    48 (32 to 67)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From day -7 during the screening period to 30 ± 3 days after the end of study treatment
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    16.1
    Reporting groups
    Reporting group title
    Panitumumab + FOLFOX 4
    Reporting group description
    Panitumumab was administered by intravenous infusion on day 1 of each cycle, just prior to administration of chemotherapy. A treatment cycle was defined as the 14 day period following treatment with panitumumab and commencement of FOLFOX 4 chemotherapy. FOLFOX 4 was administered every 2 weeks (± 3 days) as follows: Day 1: Oxaliplatin (85 mg/m2, intravenous infusion) and folinic acid (200 mg/m2, intravenous infusion), both given over 120 minutes (± 15 minutes) at the same time; followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2, intravenous infusion), given as a 22 hour (± 1 hour) continuous infusion. Day 2: Folinic acid (200 mg/m2, intravenous infusion), given over 120 minutes (± 15 minutes); followed by 5-FU (400 mg/m2, intravenous bolus), given over 2 to 4 minutes; followed by 5-FU (600 mg/m2 intravenous infusion), given as a 22-hour (± 1 hour) continuous infusion.

    Reporting group title
    Panitumumab + FOLFIRI
    Reporting group description
    Panitumumab was administered by intravenous infusion on day 1 of each cycle, just prior to administration of chemotherapy. A treatment cycle was defined as the 14 day period following treatment with panitumumab and FOLFIRI chemotherapy. FOLFIRI was administered every 2 weeks (± 3 days), on day 1 of each cycle, as follows: Irinotecan (180 mg/m2, intravenous infusion) was administered over 90 minutes ± 15 minutes. Folinic acid (400 mg/m2, intravenous infusion) was administered over 2 hours ± 15 minutes during irinotecan infusion. but without mixing. Immediately afterwards, a 5-FU intravenous bolus (400 mg/m2) was administered and a 5-FU intravenous infusion (2400 mg/m2) was given as 46-hour ± 2-hour continuous infusion.

    Serious adverse events
    Panitumumab + FOLFOX 4 Panitumumab + FOLFIRI
    Total subjects affected by serious adverse events
         subjects affected / exposed
    13 / 38 (34.21%)
    15 / 39 (38.46%)
         number of deaths (all causes)
    24
    27
         number of deaths resulting from adverse events
    2
    3
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Metastases to peritoneum
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 39 (2.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Anastomotic leak
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 39 (2.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hip fracture
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 39 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Postoperative fever
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 39 (2.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 39 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Hepatic encephalopathy
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 39 (2.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Ischaemic stroke
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 39 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 39 (2.56%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenia
         subjects affected / exposed
    2 / 38 (5.26%)
    0 / 39 (0.00%)
         occurrences causally related to treatment / all
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 39 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 39 (2.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 38 (2.63%)
    3 / 39 (7.69%)
         occurrences causally related to treatment / all
    1 / 1
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal inflammation
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 39 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    1 / 38 (2.63%)
    4 / 39 (10.26%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Localised intra-abdominal fluid collection
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 39 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 39 (2.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rectal obstruction
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 39 (2.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Biliary dilatation
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 39 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholecystitis
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 39 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholestasis
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 39 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic function abnormal
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 39 (2.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Respiratory, thoracic and mediastinal disorders
    Pneumomediastinum
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 39 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 39 (2.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Renal and urinary disorders
    Hydronephrosis
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 39 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Anal abscess
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 39 (2.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    1 / 38 (2.63%)
    1 / 39 (2.56%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Device related sepsis
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 39 (2.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Necrotising fasciitis
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 39 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Peritonitis
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 39 (2.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Septic shock
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 39 (2.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 39 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Panitumumab + FOLFOX 4 Panitumumab + FOLFIRI
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    38 / 38 (100.00%)
    39 / 39 (100.00%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    3 / 38 (7.89%)
    0 / 39 (0.00%)
         occurrences all number
    5
    0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    25 / 38 (65.79%)
    24 / 39 (61.54%)
         occurrences all number
    43
    52
    Chest pain
         subjects affected / exposed
    2 / 38 (5.26%)
    1 / 39 (2.56%)
         occurrences all number
    2
    1
    Mucosal inflammation
         subjects affected / exposed
    18 / 38 (47.37%)
    22 / 39 (56.41%)
         occurrences all number
    45
    34
    Pyrexia
         subjects affected / exposed
    11 / 38 (28.95%)
    7 / 39 (17.95%)
         occurrences all number
    14
    11
    Xerosis
         subjects affected / exposed
    3 / 38 (7.89%)
    3 / 39 (7.69%)
         occurrences all number
    3
    5
    Immune system disorders
    Drug hypersensitivity
         subjects affected / exposed
    3 / 38 (7.89%)
    0 / 39 (0.00%)
         occurrences all number
    5
    0
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    4 / 38 (10.53%)
    3 / 39 (7.69%)
         occurrences all number
    5
    3
    Dyspnoea
         subjects affected / exposed
    2 / 38 (5.26%)
    1 / 39 (2.56%)
         occurrences all number
    2
    1
    Epistaxis
         subjects affected / exposed
    3 / 38 (7.89%)
    1 / 39 (2.56%)
         occurrences all number
    6
    1
    Hiccups
         subjects affected / exposed
    1 / 38 (2.63%)
    2 / 39 (5.13%)
         occurrences all number
    1
    6
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    2 / 38 (5.26%)
    1 / 39 (2.56%)
         occurrences all number
    2
    2
    Depression
         subjects affected / exposed
    0 / 38 (0.00%)
    3 / 39 (7.69%)
         occurrences all number
    0
    3
    Insomnia
         subjects affected / exposed
    2 / 38 (5.26%)
    1 / 39 (2.56%)
         occurrences all number
    2
    1
    Investigations
    Haemoglobin decreased
         subjects affected / exposed
    0 / 38 (0.00%)
    2 / 39 (5.13%)
         occurrences all number
    0
    2
    Weight decreased
         subjects affected / exposed
    2 / 38 (5.26%)
    0 / 39 (0.00%)
         occurrences all number
    2
    0
    Injury, poisoning and procedural complications
    Infusion related reaction
         subjects affected / exposed
    2 / 38 (5.26%)
    0 / 39 (0.00%)
         occurrences all number
    2
    0
    Nail injury
         subjects affected / exposed
    0 / 38 (0.00%)
    2 / 39 (5.13%)
         occurrences all number
    0
    2
    Nervous system disorders
    Dysaesthesia
         subjects affected / exposed
    8 / 38 (21.05%)
    1 / 39 (2.56%)
         occurrences all number
    9
    1
    Dysgeusia
         subjects affected / exposed
    7 / 38 (18.42%)
    5 / 39 (12.82%)
         occurrences all number
    7
    7
    Headache
         subjects affected / exposed
    2 / 38 (5.26%)
    0 / 39 (0.00%)
         occurrences all number
    2
    0
    Neurotoxicity
         subjects affected / exposed
    20 / 38 (52.63%)
    1 / 39 (2.56%)
         occurrences all number
    32
    1
    Paraesthesia
         subjects affected / exposed
    11 / 38 (28.95%)
    2 / 39 (5.13%)
         occurrences all number
    14
    2
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    8 / 38 (21.05%)
    7 / 39 (17.95%)
         occurrences all number
    8
    8
    Leukopenia
         subjects affected / exposed
    4 / 38 (10.53%)
    0 / 39 (0.00%)
         occurrences all number
    5
    0
    Neutropenia
         subjects affected / exposed
    24 / 38 (63.16%)
    12 / 39 (30.77%)
         occurrences all number
    49
    20
    Thrombocytopenia
         subjects affected / exposed
    9 / 38 (23.68%)
    1 / 39 (2.56%)
         occurrences all number
    16
    1
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    2 / 38 (5.26%)
    0 / 39 (0.00%)
         occurrences all number
    2
    0
    Eye disorders
    Conjunctivitis
         subjects affected / exposed
    7 / 38 (18.42%)
    10 / 39 (25.64%)
         occurrences all number
    15
    16
    Dry eye
         subjects affected / exposed
    2 / 38 (5.26%)
    0 / 39 (0.00%)
         occurrences all number
    2
    0
    Trichomegaly
         subjects affected / exposed
    1 / 38 (2.63%)
    2 / 39 (5.13%)
         occurrences all number
    1
    3
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    9 / 38 (23.68%)
    2 / 39 (5.13%)
         occurrences all number
    15
    5
    Abdominal pain upper
         subjects affected / exposed
    1 / 38 (2.63%)
    3 / 39 (7.69%)
         occurrences all number
    1
    3
    Anal fissure
         subjects affected / exposed
    2 / 38 (5.26%)
    0 / 39 (0.00%)
         occurrences all number
    2
    0
    Cheilitis
         subjects affected / exposed
    5 / 38 (13.16%)
    0 / 39 (0.00%)
         occurrences all number
    9
    0
    Constipation
         subjects affected / exposed
    19 / 38 (50.00%)
    15 / 39 (38.46%)
         occurrences all number
    39
    22
    Diarrhoea
         subjects affected / exposed
    29 / 38 (76.32%)
    26 / 39 (66.67%)
         occurrences all number
    79
    68
    Dry mouth
         subjects affected / exposed
    2 / 38 (5.26%)
    1 / 39 (2.56%)
         occurrences all number
    2
    1
    Dyspepsia
         subjects affected / exposed
    0 / 38 (0.00%)
    2 / 39 (5.13%)
         occurrences all number
    0
    3
    Gastrooesophageal reflux disease
         subjects affected / exposed
    0 / 38 (0.00%)
    2 / 39 (5.13%)
         occurrences all number
    0
    2
    Haematochezia
         subjects affected / exposed
    2 / 38 (5.26%)
    1 / 39 (2.56%)
         occurrences all number
    2
    1
    Haemorrhoids
         subjects affected / exposed
    2 / 38 (5.26%)
    1 / 39 (2.56%)
         occurrences all number
    2
    1
    Nausea
         subjects affected / exposed
    15 / 38 (39.47%)
    14 / 39 (35.90%)
         occurrences all number
    24
    33
    Rectal haemorrhage
         subjects affected / exposed
    3 / 38 (7.89%)
    0 / 39 (0.00%)
         occurrences all number
    5
    0
    Stomatitis
         subjects affected / exposed
    2 / 38 (5.26%)
    3 / 39 (7.69%)
         occurrences all number
    3
    4
    Toothache
         subjects affected / exposed
    1 / 38 (2.63%)
    2 / 39 (5.13%)
         occurrences all number
    1
    2
    Vomiting
         subjects affected / exposed
    14 / 38 (36.84%)
    10 / 39 (25.64%)
         occurrences all number
    24
    33
    Proctalgia
         subjects affected / exposed
    0 / 38 (0.00%)
    3 / 39 (7.69%)
         occurrences all number
    0
    4
    Skin and subcutaneous tissue disorders
    Acne
         subjects affected / exposed
    14 / 38 (36.84%)
    5 / 39 (12.82%)
         occurrences all number
    29
    11
    Alopecia
         subjects affected / exposed
    2 / 38 (5.26%)
    10 / 39 (25.64%)
         occurrences all number
    2
    10
    Dermatitis
         subjects affected / exposed
    6 / 38 (15.79%)
    3 / 39 (7.69%)
         occurrences all number
    9
    3
    Dermatitis acneiform
         subjects affected / exposed
    5 / 38 (13.16%)
    6 / 39 (15.38%)
         occurrences all number
    6
    6
    Dry skin
         subjects affected / exposed
    5 / 38 (13.16%)
    3 / 39 (7.69%)
         occurrences all number
    7
    4
    Erythema
         subjects affected / exposed
    3 / 38 (7.89%)
    3 / 39 (7.69%)
         occurrences all number
    3
    6
    Hypertrichosis
         subjects affected / exposed
    4 / 38 (10.53%)
    1 / 39 (2.56%)
         occurrences all number
    6
    1
    Nail disorder
         subjects affected / exposed
    1 / 38 (2.63%)
    2 / 39 (5.13%)
         occurrences all number
    1
    3
    Nail toxicity
         subjects affected / exposed
    1 / 38 (2.63%)
    2 / 39 (5.13%)
         occurrences all number
    1
    2
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    3 / 38 (7.89%)
    4 / 39 (10.26%)
         occurrences all number
    3
    7
    Pruritus
         subjects affected / exposed
    6 / 38 (15.79%)
    6 / 39 (15.38%)
         occurrences all number
    8
    6
    Rash
         subjects affected / exposed
    18 / 38 (47.37%)
    26 / 39 (66.67%)
         occurrences all number
    36
    41
    Skin fissures
         subjects affected / exposed
    6 / 38 (15.79%)
    3 / 39 (7.69%)
         occurrences all number
    6
    3
    Skin toxicity
         subjects affected / exposed
    2 / 38 (5.26%)
    2 / 39 (5.13%)
         occurrences all number
    2
    3
    Telangiectasia
         subjects affected / exposed
    1 / 38 (2.63%)
    2 / 39 (5.13%)
         occurrences all number
    1
    2
    Toxic skin eruption
         subjects affected / exposed
    2 / 38 (5.26%)
    1 / 39 (2.56%)
         occurrences all number
    4
    1
    Xeroderma
         subjects affected / exposed
    0 / 38 (0.00%)
    2 / 39 (5.13%)
         occurrences all number
    0
    2
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    2 / 38 (5.26%)
    0 / 39 (0.00%)
         occurrences all number
    3
    0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    3 / 38 (7.89%)
    1 / 39 (2.56%)
         occurrences all number
    4
    1
    Back pain
         subjects affected / exposed
    2 / 38 (5.26%)
    0 / 39 (0.00%)
         occurrences all number
    3
    0
    Myalgia
         subjects affected / exposed
    2 / 38 (5.26%)
    1 / 39 (2.56%)
         occurrences all number
    2
    1
    Infections and infestations
    Device related infection
         subjects affected / exposed
    2 / 38 (5.26%)
    1 / 39 (2.56%)
         occurrences all number
    2
    1
    Folliculitis
         subjects affected / exposed
    2 / 38 (5.26%)
    1 / 39 (2.56%)
         occurrences all number
    3
    1
    Nasopharyngitis
         subjects affected / exposed
    1 / 38 (2.63%)
    3 / 39 (7.69%)
         occurrences all number
    1
    3
    Paronychia
         subjects affected / exposed
    11 / 38 (28.95%)
    11 / 39 (28.21%)
         occurrences all number
    22
    14
    Urinary tract infection
         subjects affected / exposed
    2 / 38 (5.26%)
    0 / 39 (0.00%)
         occurrences all number
    2
    0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    8 / 38 (21.05%)
    11 / 39 (28.21%)
         occurrences all number
    14
    16
    Hyperglycaemia
         subjects affected / exposed
    2 / 38 (5.26%)
    0 / 39 (0.00%)
         occurrences all number
    2
    0
    Hypomagnesaemia
         subjects affected / exposed
    9 / 38 (23.68%)
    12 / 39 (30.77%)
         occurrences all number
    14
    15
    Hypoproteinaemia
         subjects affected / exposed
    2 / 38 (5.26%)
    0 / 39 (0.00%)
         occurrences all number
    2
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    15 Dec 2008
    Removal of "Administrative decision by the study sponsor" as a reason for withdrawal of patients from study treatment or from observation. In conjunction with this Amendment, the Patient Information Sheet and Informed Consent Form were updated. Notably, a Patient Information Sheet was created for the optional new marker study. These changes were made in response to feedback from the Independent Ethics Committees involved in this study.
    03 Mar 2009
    Update to the Patient Information Sheet based on new information regarding the administration/safety of one of the study treatments (Panitumumab).
    15 Mar 2010
    Addition of 2 new secondary objectives: (1) to assess the effects of the study treatments in terms of overall survival and (2) to assess hypomagnesaemia as a predictor of response to study treatment. Modification of the study endpoints to reflect the changes in the secondary objectives. Change of definition of the adjuvant treatment regimen to 12 complete cycles (including neoadjuvant treatment cycles received before surgery) of the allocated study treatment regimen. Correction of error in age of subjects eligible for enrollment. Inclusion criteria: metastases permitted to be resectable or non-resectable (not only non-resectable). Clarification of the definition of delay to surgery due to study treatment-related toxicity. Definition of end of study modified. Specification of version of RECIST to be used. Information regarding storage and handling of Panitumumab updated. Amendment/updating of the objectives of the parallel study of genetic factors.
    24 Nov 2010
    Inclusion criteria/screening procedures: removal of the requirement for KRAS gene analysis to be performed by the designated central laboratory (thus permitting it to be performed locally). The reason for this was minimize the delay in starting treatment in eligible patients, since Spanish hospitals perform a KRAS analysis as part of routine clinical practice in patients with metastatic colorectal cancer.
    28 Feb 2011
    Update to the "SAFETY - POTENTIAL RISKS AND DISCOMFORT" section of the Patient Information Sheet based on new information regarding the safety of combination treatment with Panitumumab plus chemotherapy.
    15 May 2013
    Change of Principal Investigator at 2 of the study sites. Creation of an addendum to the Patient Information Sheet detailing new safety information, which all patients included in the study were required to sign. This was because the phase III PRIME (Panitumumab Randomized trial In combination with chemotherapy for Metastatic colorectal cancer to determine Efficacy) study had shown that patients with RAS mutations in regions other than codon 2 who received Panitumumab plus FOLFOX had lower progression-free survival and overall survival compared to patients treated with FOLFOX alone.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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