Optimal maintenance treatment strategy following an anti-EGFR-based first-line induction therapy in patients with RAS wild type metastatic colorectal cancer: An individual patient data pooled analysis of clinical trials

Abstract

Background: In metastatic colorectal cancer (mCRC), after a first-line induction with doublet/triplet chemotherapy plus bevacizumab, fluoropyrimidine+bevacizumab is the recommended maintenance option. The combination of anti-EGFR agents and chemotherapy is a guideline-endorsed first-line option for RAS/BRAF wild-type (wt) mCRC patients, but the optimal maintenance schedule has not been defined, yet. The Valentino trial showed that, after 4-month FOLFOX+panitumumab induction, singleagent panitumumab induced inferior progression-free survival (PFS) than FUFA+panitumumab, though slightly reducing toxicity. The Panama study demonstrated that, after 3-month FOLFOX+panitumumab induction, FUFA+panitumumab induced a significantly superior PFS than FUFA alone.