Background: In RAS wild type (wt) metastatic colorectal cancer (mCRC) maintenance therapy after induction with fluoropyrimidine (FP)-based cytotoxic therapy (CT) plus anti-EGFR agents is controversial. Methods: Phase II-III randomized trials were included. Maintenance strategies considered were: observation, anti-EGFR or FP monotherapy, FP + anti-EGFR, doublet CT + anti-EGFR. Results: Maintenance with FP + anti-EGFR (HR 0.56, 95% CrI 0.36–0.89) showed the greatest PFS benefit compared to observation, ranking first on SUCRA analysis (96.4%). Considering OS, doublet CT+ anti-EGFR, FP + anti-EGFR and anti-EGFR monotherapy yielded similar results. For PFS, FP + anti-EGFR confirmed to be valuable in BRAF wt patients and left sided tumors. In left sided tumors, the OS benefit of adding CT was limited. FP plus anti-EGFR showed a favourable safety profile compared to doublet CT + anti-EGFR. Conclusions: FP + anti-EGFR can be considered a valuable maintenance option in RAS wt mCRC. EGFR monotherapy can be considered, especially in left-sided tumors.
Mastrantoni, L., Beccia, V., Caira, G., Trovato, G., Calegari, M. A., Basso, M., Salvatore, L., Pozzo, C., Tortora, G., Bria, E., Orlandi, A., Maintenance strategies after anti-EGFR-based induction in metastatic colorectal cancer: A systematic review and bayesian network meta-analysis, <<CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY>>, 2023; 191 (104106): N/A-N/A. [doi:10.1016/j.critrevonc.2023.104106] [https://hdl.handle.net/10807/312430]
Maintenance strategies after anti-EGFR-based induction in metastatic colorectal cancer: A systematic review and bayesian network meta-analysis
Mastrantoni, LucaPrimo
;Beccia, Viria;Caira, Giulia;Trovato, Giovanni;Calegari, Maria Alessandra;Basso, Maria;Salvatore, Lisa;Pozzo, Carmelo;Tortora, Giampaolo;Bria, Emilio;Orlandi, ArmandoUltimo
2023
Abstract
Background: In RAS wild type (wt) metastatic colorectal cancer (mCRC) maintenance therapy after induction with fluoropyrimidine (FP)-based cytotoxic therapy (CT) plus anti-EGFR agents is controversial. Methods: Phase II-III randomized trials were included. Maintenance strategies considered were: observation, anti-EGFR or FP monotherapy, FP + anti-EGFR, doublet CT + anti-EGFR. Results: Maintenance with FP + anti-EGFR (HR 0.56, 95% CrI 0.36–0.89) showed the greatest PFS benefit compared to observation, ranking first on SUCRA analysis (96.4%). Considering OS, doublet CT+ anti-EGFR, FP + anti-EGFR and anti-EGFR monotherapy yielded similar results. For PFS, FP + anti-EGFR confirmed to be valuable in BRAF wt patients and left sided tumors. In left sided tumors, the OS benefit of adding CT was limited. FP plus anti-EGFR showed a favourable safety profile compared to doublet CT + anti-EGFR. Conclusions: FP + anti-EGFR can be considered a valuable maintenance option in RAS wt mCRC. EGFR monotherapy can be considered, especially in left-sided tumors.File | Dimensione | Formato | |
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