Patients had a small but nonsignificant survival advantage when continuing with anti-VEGF therapy in the second-line instead of switching to anti-EGFR therapy.
Continuing anti- vascular endothelial growth factor therapy plus chemotherapy in the second-line setting led to a small but nonsignificant increase in overall survival in patients with right-sided, RAS/RAF wild-type metastatic colorectal cancer compared to patients who received anti- epidermal growth factor receptor therapy plus chemotherapy.
Despite limited evidence, guidelines recommend anti-EGFR therapy plus chemotherapy in the second line for patients with RAS/RAF wild-type, right-sided tumors who did not previously receive anti-EGFR therapy. To assess whether this is the best option, the current study compared the effectiveness of continuing chemotherapy plus anti-VEGF in the second-line or using anti-EGFR plus chemotherapy.The analysis included 444 patients with RAS/RAF wild-type, right-sided metastatic CRC who received first-line chemotherapy plus anti-VEGF therapy, followed by second-line anti-VEGF therapy or anti-EGFR therapy with chemotherapy.Compared with the anti-VEGF therapy group, the anti-EGFR therapy group demonstrated a nonsignificant increased risk for death .Among patients with RAS/RAF wild-type, right-sided metastatic CRC who received first-line chemotherapy plus anti-VEGF therapy, these findings “provide some evidence for continuing anti-VEGF therapy in the second line, although the result was not statistically significant,” the authors wrote.This study was limited by possible unmeasured confounding factors and had limited statistical power due to the relatively small proportion of mCRC cases that were right-sided and RAS/RAF wild-type.No funding information was provided for this study. Several authors reported receiving grants and personal fees and having other ties with various sources. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our
Colorectal Cancer (CRC) Genomics Genomic Medicine VEGF Vascular Endothelial Growth Factor Vascular Endothelial Growth Factor (VEGF) Epidermal Growth Factor Receptor EGFR Epidermal Growth Factor Receptor (EGFR) Metastatic Colorectal Cancer Metastatic CRC Mcrc Metastatic Colorectal Cancer (Mcrc) Chemotherapy Electronic Health Record EHR Electronic Health Record (EHR)
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