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Metastatic Colorectal Cancer Phase 3 Randomized NCT01996306

AXEPT: Complete Statistical Analysis of XELIRI ± Bevacizumab in Metastatic Colorectal Cancer

An independent statistical review of the randomized phase 3 AXEPT trial evaluating 2nd-line XELIRI ± bevacizumab versus FOLFIRI ± bevacizumab in metastatic colorectal cancer.

AXEPT · NCT01996306 · Completed
Scope of this record

This page provides an independent statistical analysis and educational interpretation of publicly reported results. ClinicalTrials.gov provides the official trial registry record.

1. Trial at a Glance

AXEPT was a randomized phase 3 treatment trial comparing two second-line chemotherapy strategies for metastatic colorectal cancer.

650
Enrollment
2
Treatment Arms
3
Phase
2013–2017
Trial Period
FeatureAXEPT
NCT IDNCT01996306
TitleA Phase III Study of 2nd-line XELIRI ± Bevacizumab vs. FOLFIRI ± Bevacizumab in mCRC
StatusCOMPLETED
AllocationRANDOMIZED
Design modelPARALLEL
MaskingNONE
Primary purposeTREATMENT

2. Clinical Question

Population

Patients with colorectal neoplasms and related metastatic gastrointestinal malignancies enrolled in the AXEPT study.

Intervention

XELIRI ± bevacizumab, including irinotecan and capecitabine-based therapy.

Comparator

FOLFIRI ± bevacizumab, including irinotecan, 5-FU, leucovorin, and bevacizumab-based therapy.

Primary question

Comparison of overall survival between randomized treatment groups.

3. Trial Design

Allocation

Randomized parallel-group phase 3 design.

Arms

Two treatment arms.

Enrollment

650 participants.

Sponsor

Epidemiological and Clinical Research Information Network.

4. Endpoints

EndpointDefinitionTime Frame
Overall survivalTime from the date of enrollment to death from any cause.Assessed until 1.5 years after the last patient enrolment.

5. Planned Analysis

The ClinicalTrials.gov record identifies overall survival as the primary endpoint but does not report posted statistical analyses or outcome estimates.

For an endpoint defined as time from enrollment to death from any cause, a typical analysis would use time-to-event methods. These methods account for patients whose event time is not observed during follow-up through censoring and allow comparison of survival distributions between randomized groups.

ClinicalTrials.gov reporting status:

No formal statistical analyses were posted to ClinicalTrials.gov.

6. Statistical Methodology

Time-to-event analysis

Overall survival is a time-to-event endpoint. Statistical methods for this endpoint generally focus on the distribution of survival times rather than simply comparing proportions at a single time point.

Censoring

When follow-up ends before an event occurs, survival methods allow available follow-up information to contribute without treating those observations as failures.

Randomized comparison

Randomization creates the framework for comparing treatment groups while reducing the influence of measured and unmeasured baseline differences.

7. Statistical Methods Explained

Why is overall survival a time-to-event endpoint?

Overall survival measures the time until death from any cause, making the timing of events important rather than only whether an event occurred.

Why are survival methods used?

Patients may have different follow-up durations. Survival methods incorporate incomplete follow-up through censoring.

What does a hazard ratio represent?

If reported, a hazard ratio would compare estimated instantaneous event rates between treatment groups under a statistical model. It would not represent the percentage of patients who survive.

Why does randomization matter?

Randomization supports a fair comparison by assigning treatment groups without investigator choice.

Why are confidence intervals important?

Confidence intervals describe uncertainty around an estimate and help distinguish precise estimates from estimates with substantial uncertainty.

8. Limitations

9. Why This Trial Matters Statistically

ConceptHow it appears in AXEPT
RandomizationParallel randomized treatment comparison.
Phase 3 designConfirmatory clinical trial framework.
Overall survivalPrimary time-to-event endpoint.
CensoringImportant consideration for survival follow-up.
Comparative effectivenessTwo chemotherapy strategies evaluated.

10. Related Tutorials

11. Related Calculators

12. Sources