Results of Pivotal TAILOR Study Confirm Addition of Erbitux to FOLFOX Significantly Improves Outcomes in RAS Wild-Type Metastatic Colorectal Cancer

Friday 01 July 2016 16:02
Not intended for UK- or US-based media

WCGC Abstract # 0-025; poster presentation, July 1, 2016, 10:35 am CEST

- Phase III study shows response rate of 61.1% for patients treated with Erbitux plus FOLFOX

- 31% decrease in risk of disease progression and 24% decrease in risk of death was achieved with addition of Erbitux to FOLFOX

- First prospective study to evaluate Erbitux in RAS wild-type patients

Merck, a leading science and technology company, will present data at the ESMO 18th World Congress on Gastrointestinal Cancer (WCGC) from the pivotal Phase III TAILOR study in patients from China, the first prospective trial to evaluate an anti-EGFR antibody in the first-line therapy of patients with RAS wild-type metastatic colorectal cancer (mCRC). The results demonstrate that Erbitux(R) (cetuximab) plus FOLFOX statistically significantly improves outcomes, including progression-free survival (PFS; primary endpoint), overall survival (OS) and best overall response rate (bORR), compared with FOLFOX alone.[1]

Notably, compared with those receiving FOLFOX alone, patients in the study receiving Erbitux plus FOLFOX experienced:[1]

- a bORR of 61.1% (versus 39.5%; odds ratio [OR]: 2.41; p<0.001), which is in line with international studies

- a 31% decrease in the risk of disease progression (hazard ratio [HR]: 0.69; p=0.004); and,

- a 24% reduction in the risk of death (HR: 0.76; p=0.02).

"As a standard-of-care treatment, Erbitux is a strategic priority product for Merck and our aspiration is that patients have optimal access to this drug worldwide," said Luciano Rossetti, Executive Vice President, Global Head of Research & Development in the biopharma business of Merck. "We are confident the TAILOR results form a good basis upon which approval could be extended to first-line metastatic colorectal cancer treatment in China."

The TAILOR study randomized 393 patients from China with RAS wild-type mCRC, and the results demonstrate that adding Erbitux to FOLFOX, as a first-line treatment, significantly improves PFS (median PFS: 9.2 vs 7.4 months) and OS (median OS: 20.7 vs 17.8 months). The safety profile of Erbitux observed in TAILOR is similar to that seen in prior randomized clinical trials, with no unexpected safety findings.[1]

"The results of the TAILOR study further reaffirm that Erbitux plus FOLFOX as chemotherapy backbone is an effective treatment regimen for patients with RAS wild-type mCRC, as we have seen in previous international pivotal studies, such as OPUS," said Prof. Carsten Bokemeyer, University Medical Center, Hamburg-Eppendorf, Germany and primary investigator of the OPUS study. "As the first prospective trial evaluating Erbitux in RAS wild-type patients, the TAILOR results reinforce the value and importance of RAS biomarker testing in order to determine the appropriate targeted therapy for individual patients, based on their tumor's genetic make-up."

Both the National Comprehensive Cancer Network (U.S.) and the European Society for Medical Oncology clinical guidelines recommend first-line treatment with Erbitux plus either FOLFOX or FOLFIRI for patients with RAS wild-type mCRC.[3],[4]

"There are currently limited first-line options available in China for patients with RAS wild-type metastatic colorectal cancer," said Professor Shukui Qin from Nanjing Bayi Hospital, China, Coordinating Investigator in the TAILOR study. "The results of the TAILOR study strongly support the benefit of Erbitux in the treatment of these patients, and we are hopeful it will soon be approved so that patients in this country will be able to access treatment options that they so desperately need."

Erbitux has obtained marketing authorization in over 90 countries worldwide. In Europe, Erbitux is indicated as first-line therapy for patients with RAS wild-type mCRC tumors, together with the oxaliplatin-containing regimen FOLFOX in treatment-naive patients or together with regimens containing irinotecan (e.g. FOLFIRI).[3-5] More than 442,000 patients with mCRC have been treated with Erbitux.

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References

1) Qin S, et al. Ann Oncol 2016;27(Suppl 4):0-025.

2) Bokemeyer C et al. J Clin Oncol 2014;25:(Suppl 2):ii 105-17

3) National Comprehensive Cancer Network (NCCN). Clinical Practice Guidelines in Oncology (NCCN Guidelines). Colon Cancer. Version 2.2016. Available from: http://www.nccn.org/patients . Accessed June 2016.

4) Van Cutsem E et al. Ann Oncol 2014;25(Suppl 3):iii 1-9.

5) Erbitux(R) (cetuximab) SmPC, Last updated June 2014. Available at: http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000558/WC500029119.pdf . Accessed June 2016.

6) Vaughn CP et al. Genes Chromosomes Cancer 2011;50(5):307−12.

7) Van Cutsem E et al. J Clin Oncol 2015;33(7):692-700.

8) Stintzing S et al. Oral presentation at the 2014 European Society for Medical Oncology Congress, September 26-30, 2014. Abstract No:LBA11.

9) Lenz H et al. Ann Oncol 2014;25(Suppl 5):v1-41.

10) Ferlay J, et al. Int J Cancer 2015;136:E359-86.

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About the TAILOR study

The TAILOR study is a prospective, Phase III, open-label, randomized, controlled, multicenter trial designed to compare Erbitux in combination with FOLFOX-4 versus FOLFOX-4 alone in the first-line treatment of patients in China with RAS wild-type mCRC. All randomized subjects were planned to receive treatment until the occurrence of progressive disease (PD) or unacceptable toxicity. The study enrolled 397 patients with RAS wild-type mCRC. The primary endpoint of the trial is PFS. Secondary endpoints include: OS, best ORR, time to treatment failure and rate of curative surgery for liver metastases.

About mCRC

Approximately half of patients with mCRC have RAS wild-type tumors and half have RAS mutant tumors.[6] Results from studies assessing RAS mutation status in patients with mCRC have shown that anti-epidermal growth factor receptor (EGFR) monoclonal antibody therapies, such as Erbitux(R) (cetuximab), can improve outcomes in patients with RAS wild-type mCRC. [2],[7]-[9] Colorectal cancer (CRC) is the third most common cancer worldwide, with an estimated incidence of more than 1.36 million new cases annually.[10] An estimated 694,000 deaths from CRC occur worldwide every year, accounting for 8.5% of all cancer deaths and making it the fourth most common cause of death from cancer.[10] Almost 55% of CRC cases are diagnosed in developed regions of the world, and incidence and mortality rates are substantially higher in men than in women.[10]

About Erbitux

Erbitux(R) is a highly active IgG1 monoclonal antibody targeting EGFR. As a monoclonal antibody, the mode of action of Erbitux is distinct from standard non-selective chemotherapy treatments in that it specifically targets and binds to the EGFR. This binding inhibits the activation of the receptor and the subsequent signal-transduction pathway, which results in reducing both the invasion of normal tissues by tumor cells and the spread of tumors to new sites. It is also believed to inhibit the ability of tumor cells to repair the damage caused by chemotherapy and radiotherapy and to inhibit the formation of new blood vessels inside tumors, which appears to lead to an overall suppression of tumor growth.

The most commonly reported side effect with Erbitux is an acne-like skin rash that seems to be correlated with a good response to therapy. In approximately 5% of patients, hypersensitivity reactions may occur during treatment with Erbitux; about half of these reactions are severe.

Erbitux has already obtained market authorization in over 90 countries world-wide for the treatment of colorectal cancer and for the treatment of squamous cell carcinoma of the head and neck (SCCHN). Merck licensed the right to market Erbitux outside the US and Canada from ImClone LLC, a wholly-owned subsidiary of Eli Lilly and Company, in 1998. Merck has an ongoing commitment to the advancement of oncology treatment and is currently investigating novel therapies in highly targeted areas.

About Merck

Merck is a leading science and technology company in healthcare, life science and performance materials. Around 50,000 employees work to further develop technologies that improve and enhance life - from biopharmaceutical therapies to treat cancer or multiple sclerosis, cutting-edge systems for scientific research and production, to liquid crystals for smartphones and LCD televisions. In 2015, Merck generated sales of EUR 12.85 billion in 66 countries.

Founded in 1668, Merck is the world's oldest pharmaceutical and chemical company. The founding family remains the majority owner of the publicly listed corporate group. Merck, Darmstadt, Germany holds the global rights to the Merck name and brand. The only exceptions are the United States and Canada, where the company operates as EMD Serono, MilliporeSigma and EMD Performance Materials.

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Source: Merck