David Kerr, MD, of the University of Oxford, United Kingdom, who is also President of the European Society of Medical Oncology, formally discussed the study, which he called “well designed and well conducted.” He applauded the investigators for performing a preplanned subgroup analysis with a priori biologic rationale rather than “sifting through the data post hoc” to look for associations, but he noted that subgroup analyses, even preplanned, should always be considered hypothesis-generating.

Nevertheless, he maintained that the key findings from VELOUR do “change the landscape” of the second-line treatment of advanced disease, which currently contains several effective options. “We have a new agent to consider,” he said, “for those patients who progress following front-line treatment with FOLFOX (leucovorin, fluorouracil, oxaliplatin) with or without bevacizumab (Avastin).” ■

Disclosure: Dr. Kerr reported no potential conflicts of interest.