Amgen announced top-line results from a randomized phase 3 trial evaluating Vectibix (panitumumab) as a first-line treatment in patients with recurrent and/or metastatic squamous cell head and neck cancer. The data showed the addition of Vectibix to platinum-based chemotherapy did not result in a statistically significant improvement in overall survival, the primary endpoint, compared to chemotherapy alone [median 11.1 months versus 9.0 months, hazard ratio 0.87 (95% CI: 0.73, 1.05)]. Therefore, the study did not meet its primary endpoint. Secondary endpoints of progression-free survival [median 5.8 months versus 4.6 months, hazard ratio 0.78 (95% CI: 0.66, 0.92)] and objective response rate (36 per cent versus 25 per cent) were numerically improved but were not tested for statistical significance.

"The outcome of this study is disappointing. However, Vectibix remains an important monotherapy treatment option for patients with metastatic colorectal cancer whose disease has progressed on other therapies," said Roger M. Perlmutter, M.D., Ph.D., executive vice president of Research and Development at Amgen.

The SPECTRUM study enrolled 658 patients who were randomized to receive a standard platinum-based chemotherapy (cisplatin and 5-FU), with or without Vectibix (9 mg/kg) every three weeks. The primary endpoint was overall survival. The secondary endpoints included progression-free survival, objective response rate, duration of response, time to progression, time to response, patient reported outcomes and safety.

The most frequently reported adverse events in the Vectibix plus chemotherapy arm included nausea, rash, neutropenia and vomiting, as anticipated for this combination therapy.

Detailed results from the study will be presented at the 35th European Society for Medical Oncology (ESMO) Congress scheduled for October 8-12 in Milan, Italy.

Oral, head and neck cancer is the sixth most common cancer in the world, with more than 400,000 new cases diagnosed each year. Most head and neck cancers begin in the epithelial cells that line the mucosal surfaces in the head and neck area, e.g., mouth, nose, and throat, and are squamous cell cancers. However, some head and neck cancers begin in other types of cells. Squamous cell cancers of the head and neck are further classified by the area in which they originate: oral cavity, pharynx, or larynx.

Currently, there are no screening methods that have been proven to increase survival rates for head and neck cancer. However, survival is highly dependent on the stage at which it is diagnosed. The treatment plan for an individual patient depends on a number of factors, including the exact location of the tumour, the stage of the cancer, and the person's age and general health.

Vectibix is the first fully human anti-EGFR antibody approved by the US Food and Drug Administration (FDA) for the treatment of metastatic colorectal cancer (mCRC). Vectibix was approved in the United States (US) in September 2006 as a monotherapy for the treatment of patients with EGFR expressing mCRC after disease progression on or following fluoropyrimidine-, oxaliplatin-, and irinotecan-containing chemotherapy regimens.

The effectiveness of Vectibix as a single agent for the treatment of EGFR-expressing, metastatic colorectal carcinoma is based on progression-free survival. Currently no data are available that demonstrate an improvement in disease-related symptoms or increased survival with Vectibix. Vectibix has not shown a treatment benefit for patients whose tumours had KRAS mutations in codon 12 or 13.

In December 2007, the European Commission granted a conditional marketing authorization for Vectibix as monotherapy for the treatment of patients with EGFR-expressing mCRC with wild-type KRAS genes after failure of standard chemotherapy regimens. Vectibix has been launched in over 20 countries, Switzerland, Australia and Canada. Applications in the rest of the world are pending.

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