PARADIGM
Proved that for RAS-normal tumours starting on the left side of the colon, an EGFR antibody beats the VEGF antibody as first partner for chemotherapy.
Left-sided primaries: OS 37.9 vs 34.3 months (HR 0.82), the longest median OS in a first-line phase 3 at the time; no benefit in right-sided tumours. Confirmed the sidedness principle from FIRE-3 and CALGB 80405 subgroup analyses and made 'left-sided, RAS/BRAF wild-type' the anti-EGFR population in guidelines.
- Median 37.9 vs 34.3 months with Panitumumab + mFOLFOX6 compared with Bevacizumab + mFOLFOX6; about 3.6 months longer for half the group.
- A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
- Put another way, the treated group had about 18 percent lower chance of the event at any given time (hazard ratio 0.82, likely range 0.68 to 0.99).
- Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.
- These results apply to the people the trial enrolled: First-line RAS wild-type metastatic colorectal cancer: panitumumab + mFOLFOX6 vs bevacizumab + mFOLFOX6. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
823 participants enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Overall survival, left-sidedprimary | Panitumumab + mFOLFOX6 | — | 37.9 months | 0.82 (0.68–0.99) | 0.031 | link |
| Bevacizumab + mFOLFOX6 | — | 34.3 months |
Pages like this
not linked directly; found by shared links- TrialCRYSTAL & FIRE-3
Shares Sidedness (left vs right colon), Anti-EGFR antibody + chemotherapy in left-sided RAS/BRAF wild-type mCRC, Bevacizumab, EGFR.
- ProductFOLFIRI (5-FU, leucovorin, irinotecan)
Shares Anti-EGFR antibody + chemotherapy in left-sided RAS/BRAF wild-type mCRC, FOLFOX (5-FU, leucovorin, oxaliplatin), Colorectal cancer.
- TrialSUNLIGHT
Shares Bevacizumab, VEGF / VEGFR, Colorectal cancer.
- TrialCodeBreaK 300
Shares Panitumumab, EGFR, Colorectal cancer.
- PersonAlan P. Venook
Shares VEGF / VEGFR, EGFR, Colorectal cancer.
- CollectionColorectal Cancer Alliance
- TechnologyVitamin D and omega-3 supplementation
Shares FOLFOX (5-FU, leucovorin, oxaliplatin), Bevacizumab, Colorectal cancer.
- TrialBREAKWATER
Shares FOLFOX (5-FU, leucovorin, oxaliplatin), EGFR, Colorectal cancer.