Christina Wu, MD, a gastrointestinal oncologist at the Mayo Clinic in Arizona, emphasized the importance of the IMPROVE study in a Highlights of the Day Session at the 2022 ASCO Annual Meeting. She said the results are not only clinically relevant but practice-changing, and they are in line with the growing concept of treatment de-escalation in some patients.
IMPROVE showed that FOLFIRI (fluorouracil, leucovorin, irinotecan) plus panitumumab can be given intermittently rather than continuously, without compromising outcomes and perhaps improving quality of life, Dr. Wu summarized. In the study, patients received eight cycles of the regimen and then stopped, with treatment reintroduced again at disease progression, followed by another treatment-free interval (depending on tumor response), and so forth.
The intermittent arm actually had a longer median progression-free survival on treatment than continuous therapy (17.1 months vs 13.2 months). For left-sided primary tumors the difference was even greater: 20.2 months vs 13.2 months.
Response rates were comparable, “so we don’t lose that by giving therapy intermittently,” she added. “And we see a decrease in skin-related toxicities from the anti-EGFR [epidermal growth factor receptor] antibody. As we are trying to improve survival, we want to be thoughtful of our patients and their quality of life.”
Dr. Wu concluded, “We can consider intermittent chemotherapy and panitumumab, and this will greatly decrease cost and also patient toxicities.”
DISCLOSURE: Dr. Wu has received honoraria from Oncology Learning Network and PrecisCa; has served in a consulting or advisory role for Array BioPharma, Daiichi Sankyo/Lilly, Natera, Nova Research Company, and Pfizer; and has received institutional research funding from Boston Biomedical, InhibRx, Lycera, RAPT Therapeutics, Seattle Genetics, Symphogen, and Vaccinex.
