Evidence map›Paper›PMID 37441876›Full record

Trial reportESMO open2023

Impact of sex on the efficacy and safety of panitumumab plus fluorouracil and folinic acid versus fluorouracil and folinic acid alone as maintenance therapy in RAS WT metastatic colorectal cancer (mCRC). Subgroup analysis of the PanaMa-study (AIO-KRK-0212).

K Heinrich, M Karthaus, S Fruehauf, U Graeven, L Mueller, A O König, L Fischer von Weikersthal, K Caca, A Kretzschmar, E Goekkurt and 10 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in ESMO open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.1field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Review
  2. Article
  3. Gender and sex differences in colorectal cancer screening, diagnosis and treatment.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025
    Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 15 institutions in 2 countries.

K HeinrichDepartment of Medicine III, University Hospital, LMU Munich, Munich; German Cancer Consortium (DKTK), Partner Site Munich, Munich. Electronic address: https://twitter.com/heinrich_kat.
M KarthausDepartment of Hematology and Oncology, Munich Hospital Neuperlach, Munich.
S FruehaufDr Hancken Hospital, Stade.
U GraevenKliniken Maria Hilf GmbH, Moenchengladbach.
L MuellerOncology Practice UnterEms, Leer.
A O KönigDepartment of Gastroenterology, University Medicine Göttingen, Goettingen.
L Fischer von WeikersthalGesundheitszentrum St Marien, Amberg.
K CacaDepartment of Gastroenterology, Hematology and Oncology, Hospital Ludwigsburg, Ludwigsburg.
A KretzschmarMVZ Mitte, Leipzig.
E GoekkurtPractice of Hematology and Oncology (HOPE), Hamburg; University Cancer Center Hamburg (UCCH), Hamburg.
S HaasDepartment of Hematology and Oncology, Friedrich-Ebert-Hospital, Neumünster.
A H S AligDepartment of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin.
A KurreckDepartment of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin.
A StahlerDepartment of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin.
S HeldClinAssess GmbH, Leverkusen.
G SommerhäuserDepartment of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin.
V HeinemannDepartment of Medicine III, University Hospital, LMU Munich, Munich; German Cancer Consortium (DKTK), Partner Site Munich, Munich; Comprehensive Cancer Center, University Hospital (LMU), Munich.
S StintzingDepartment of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg.
T TrarbachReha-Zentrum am Meer, Bad Zwischenahn; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany.
D P ModestDepartment of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg. Electronic address: dominik.modest@charite.de.
Freie Universität Berlin · DEHumboldt-Universität zu Berlin · DECharité - Universitätsmedizin Berlin · DEClinAssess (Germany) · DEDeutschen Konsortium für Translationale Krebsforschung · DEEssen University Hospital · DEFriedrich-Ebert-Krankenhaus · DEKliniken Maria Hilf · DEKlinikum Ludwigsburg · DEKlinikum St. Marien Amberg · DELMU Klinikum · DEMedizinisches Versorgungszentrum Prof. Mathey, Prof. Schofer · DEMünchen Klinik Neuperlach · DEUniversitätsmedizin Göttingen · DEUniversity Cancer Center Hamburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical trials in metastatic colorectal cancer (mCRC) are usually conducted irrespective of sex. Sex-associated differences relating to safety and efficacy in the treatment of mCRC, however, are gaining interest.

methodsPanaMa investigated the efficacy of panitumumab (Pmab) plus fluorouracil and folinic acid (FU/FA) versus FU/FA alone after induction therapy with six cycles of FU/FA and oxaliplatin plus Pmab in patients with RAS wild-type mCRC. In this post hoc analysis, the study population was stratified for sex. Evaluated efficacy endpoints during maintenance treatment were progression-free survival (PFS, primary endpoint of the trial), overall survival (OS) and objective response rate during maintenance therapy. Safety endpoints were rates of any grade and grade 3/4 adverse events during maintenance therapy.

resultsIn total, 165 male and 83 female patients were randomized and treated. Male and female patients showed numerically better objective response rates with Pmab, without reaching statistical significance. Male patients derived a significant benefit from the addition of Pmab to maintenance treatment with regard to PFS [hazard ratio (HR) 0.63; 95% confidence interval (CI) 0.45-0.88; P = 0.006] that was not observed in female patients (HR 0.85; 95% CI 0.53-1.35; P = 0.491). The better PFS for male patients treated with Pmab did not translate into improved OS (HR 0.85; 95% CI 0.55-1.30; P = 0.452). Female patients showed numerically improved OS when treated with Pmab. There was no difference in the total of grade ≥3 adverse events during maintenance regarding sex (P = 0.791). Female patients, however, had a higher rate of any grade nausea, diarrhea and stomatitis.

conclusionsIn the PanaMa trial, the addition of Pmab to maintenance treatment of RAS wild-type mCRC with FU/FA improved the outcome in terms of the primary endpoint (PFS) particularly in male patients. Female patients did not show the same benefit while experiencing higher rates of adverse events. Our results support the development of sex-specific protocols.

Indexed as

Colonic NeoplasmsColorectal NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsFemaleFluorouracilHumansLeucovorinMalePanitumumabTreatment OutcomeFluorouracilLeucovorinPanitumumabcolorectal cancerEGFR-antibodiesmaintenancesex

Identifiers

PMID37441876
PMCPMC10507735
OpenAlexW4383901445

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.