Emily Chan, MD, PhD, Assistant Professor of Medicine, Vanderbilt University Department of Medicine, Division of Hematology/Oncology, Vanderbilt-Ingram Cancer Center, discusses the findings of the NO147 trial that examined adjuvant stage III colon cancer treatment.

The NO147 trial compared chemotherapy regimens with or without the addition of cetuximab (Erbitux) as an adjuvant treatment. The study initially planned to enroll 2300 patients but amended the goal to 3700 when a link between anti-epidermal growth factor receptor (EGFR) agents and KRAS status was discovered.

The study found that metastatic colorectal cancer with a KRAS mutation were unlikely to benefit from EGFR antibody therapies such as cetuximab or panitumumab (Vectibix). The NO147 trial arm receiving 5-fluorouracil (5-FU), folinic acid and oxaliplatin (modified [m]FOLFOX-6) plus cetuximab did not demonstrate any benefit for both mutated and wild-type KRAS tumors.

A small subsection of the trial demonstrated an improved outcome for wild type or mutated KRAS patients receiving 5-FU, FA, and irinotecan (FOLFIRI) plus cetuximab compared to FOLFIRI alone. These findings were surprising and will be the topic of further study.