Results of the phase III “Fire” trials were recently published in the medical journal The Lancet Oncology. The results of the study suggest that patients with metastatic colorectal cancer treated with Erbitux (cetuximab) combined with standard first-line FOLFIRI chemotherapy survive longer compared with FOLFIRI plus Avastin (bevacizumab).

The study analyzed data from 592 patients with KRAS 2 wild-type colon cancer treated with FOLFORI and either Erbitux or Avastin at 116 Austrian and German cancer centers. This is the first randomized clinical study directly comparing these two treatment regimens.

Overall response rates and duration of treatment were similar in both groups of patients. Patients have been followed approximately 3 years from treatment and both Eributx, and Avastin treated patients survived an average of 10 months without cancer progression. The average overall survival however favored Erbitux. Erbitux treated patients survived an average of 28.7 months compared to 25 months for Avastin treated patients.

In a subgroup analysis of patients whose cancer had no RAS mutations in any exon, there was an even wider difference with Erbitux treated patients surviving an average of 33.1 months compared to 25.6 months for Avastin treated patients.

The authors concluded that FOLFIRI plus Erbitux should be the chosen first-line treatment regimen for patients with RAS wild-type metastatic colorectal cancer.

Reference: Heinemann V, von Wekersthal L, Decker T, et al. FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab as first-line treatment for patients with metastatic colorectal cancer (FIRE-3): a randomised, open-label, phase 3 trial. The Lancet Oncology. Volume 15, No. 10, p1065–1075, September 2014.

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