Expert Point of View: Miriam Koopman, MD, PhD
Miriam Koopman, MD, PhD
Abstract discussant Miriam Koopman, MD, PhD, Professor of Medical Oncology at the University Medical Center, Utrecht, the Netherlands, and Vice Chair of the Dutch Colorectal Cancer Group, commented that CodeBreaK 300 showed a high degree of tumor shrinkage and a significant progression-free survival benefit with sotorasib plus panitumumab in heavily pretreated patients with metastatic colorectal cancer. She noted that the median progression-free survival of 2.2 months in the control arm is comparable to that seen in other phase III trials with trifluridine-tipiracil or regorafenib, “supporting the validity of the outcome of sotorasib and panitumumab in CodeBreaK.”
However, she cautioned, with only slightly more than 50 patients per arm, “the phase III nature of the study can be questioned.” Moreover, Dr. Koopman maintained, “improvement in progression-free survival alone is not enough in a late-line metastatic setting. We really need overall survival data.”
Dr. Koopman also suggested that, based on the results from the phase III SUNLIGHT trial,1 bevacizumab plus trifluridine-tipiracil could be a new standard for last-line treatment of patients with metastatic colorectal cancer. This regimen led to a median progression-free survival of almost 6 months and a median overall survival of 11 months in the SUNLIGHT study, she noted.
The study, however, lacked a subgroup analysis of patients with KRAS G12C mutations, noted Dr. Koopman. “Of four randomized late-line phase III trials in patients with metastatic colorectal cancer that included trifluridine-tipiracil or regorafenib as a treatment arm, CodeBreaK 300 is the only one that included exclusively patients with metastatic colorectal cancer with a KRAS G12C mutation,” she noted. “We need a comparison of sotorasib plus panitumumab vs bevacizumab plus trifluridine-tipiracil” in that patient subset, she suggested.
DISCLOSURE: Dr. Koopman reported financial relationships with Amgen, Bayer, Bristol Myers Squibb, GSK, Merck Serono, Nordic Pharma, Personal Genome Diagnostics, Pierre Fabre, Roche, Servier, Sirtex, and Sanofi-Aventis.
1. Prager GW, Taieb J, Fakih M, et al: Trifluridine-tipiracil and bevacizumab in refractory metastatic colorectal cancer. N Engl J Med 388:1657-1667, 2023.
The combination of sotorasib and panitumumab significantly improved progression-free survival compared with standard treatment in patients with chemotherapy-refractory metastatic colorectal cancer with KRAS G12C mutations, the phase III CodeBreaK 300 trial has shown. The KRAS G12C inhibitor...