Show simple item record

dc.contributor.authorSeligmann, J. F.
dc.contributor.authorFisher, D. J.
dc.contributor.authorBrown, L. C.
dc.contributor.authorAdams, R. A.
dc.contributor.authorGraham, J.
dc.contributor.authorQuirke, P.
dc.contributor.authorRichman, S. D.
dc.contributor.authorButler, R.
dc.contributor.authorDomingo, E.
dc.contributor.authorBlake, A.
dc.contributor.authorYates, E.
dc.contributor.authorBraun, Michael S
dc.contributor.authorCollinson, F.
dc.contributor.authorJones, R.
dc.contributor.authorBrown, E.
dc.contributor.authorde Winton, E.
dc.contributor.authorHumphrey, T. C.
dc.contributor.authorParmar, M.
dc.contributor.authorKaplan, R.
dc.contributor.authorWilson, R. H.
dc.contributor.authorSeymour, M.
dc.contributor.authorMaughan, T. S.
dc.date.accessioned2021-09-30T11:56:05Z
dc.date.available2021-09-30T11:56:05Z
dc.date.issued2021en
dc.identifier.citationSeligmann JF, Fisher DJ, Brown LC, Adams RA, Graham J, Quirke P, et al. Inhibition of WEE1 Is Effective in TP53- and RAS-Mutant Metastatic Colorectal Cancer: A Randomized Trial (FOCUS4-C) Comparing Adavosertib (AZD1775) With Active Monitoring. JCO. 2021 Sep 18;JCO.21.01435.en
dc.identifier.pmid34538072en
dc.identifier.doi10.1200/jco.21.01435en
dc.identifier.urihttp://hdl.handle.net/10541/624612
dc.description.abstractPurpose: Outcomes in RAS-mutant metastatic colorectal cancer (mCRC) remain poor and patients have limited therapeutic options. Adavosertib is the first small-molecule inhibitor of WEE1 kinase. We hypothesized that aberrations in DNA replication seen in mCRC with both RAS and TP53 mutations would sensitize tumors to WEE1 inhibition. Methods: Patients with newly diagnosed mCRC were registered into FOCUS4 and tested for TP53 and RAS mutations. Those with both mutations who were stable or responding after 16 weeks of chemotherapy were randomly assigned 2:1 between adavosertib and active monitoring (AM). Adavosertib (250 mg or 300 mg) was taken orally once on days 1-5 and days 8-12 of a 3-week cycle. The primary outcome was progression-free survival (PFS), with a target hazard ratio (HR) of 0.5 and 80% power with a one-sided 0.025 significance level. Results: FOCUS4-C was conducted between April 2017 and Mar 2020 during which time 718 patients were registered; 247 (34%) were RAS/TP53-mutant. Sixty-nine patients were randomly assigned from 25 UK hospitals (adavosertib = 44; AM = 25). Adavosertib was associated with a PFS improvement over AM (median 3.61 v 1.87 months; HR = 0.35; 95% CI, 0.18 to 0.68; P = .0022). Overall survival (OS) was not improved with adavosertib versus AM (median 14.0 v 12.8 months; HR = 0.92; 95% CI, 0.44 to 1.94; P = .93). In prespecified subgroup analysis, adavosertib activity was greater in left-sided tumors (HR = 0.24; 95% CI, 0.11 to 0.51), versus right-sided (HR = 1.02; 95% CI, 0.41 to 2.56; interaction P = .043). Adavosertib was well-tolerated; grade 3 toxicities were diarrhea (9%), nausea (5%), and neutropenia (7%). Conclusion: In this phase II randomized trial, adavosertib improved PFS compared with AM and demonstrates potential as a well-tolerated therapy for RAS/TP53-mutant mCRC. Further testing is required in this sizable population of unmet need.en
dc.language.isoenen
dc.relation.urlhttps://dx.doi.org/10.1200/jco.21.01435en
dc.titleInhibition of WEE1 is effective in TP53- and RAS-mutant metastatic colorectal cancer: a randomized trial (FOCUS4-C) comparing adavosertib (AZD1775) with active monitoringen
dc.typeArticleen
dc.contributor.departmentLeeds Institute of Medical Research, University of Leeds, Leeds, United Kingdomen
dc.identifier.journalJournal of Clinical Oncologyen
dc.description.noteen]
refterms.dateFOA2021-10-13T08:33:36Z


Files in this item

Thumbnail
Name:
34538072.pdf
Size:
756.3Kb
Format:
PDF
Description:
From CORE

This item appears in the following Collection(s)

Show simple item record