TITLE:
Efficacy of Bevacizumab versus Epidermal Growth Factor Receptor Inhibitors for Ras Wild Type Metastatic Colorectal Cancer: A Real-World Data Analysis from a Tertiary Care Institution
AUTHORS:
Lamiae Amaadour, Soumia Berrad, Ibtissam El Harch, Karima Oualla, Samia Arifi, Karima El Ghazi, Laila Chbani, Zineb Benbrahim, Nawfel Mellas
KEYWORDS:
Colorectal Cancer, Advanced Disease, First-line, Biologics, Survival
JOURNAL NAME:
Open Access Library Journal,
Vol.10 No.1,
January
17,
2023
ABSTRACT: Introduction: A combination of chemotherapy regimen and biologics in patients with RAS wild-type (wt) metastatic colorectal cancer (mCRC) resulted in improvements in survival. However, the optimal choice of initial biologic therapy in previously untreated patients remains challenging. Aim: The objective of this study is to compare the efficacy and safety outcomes of first-line epidermal growth factor receptor (EGFR) inhibitors versus vascular endothelial growth factor (VEGF) inhibitors in patients with RAS wtmCRC. Methods: A retrospective analytical study of patients with RAS wtmCRC who received first-line chemotherapy with either bevacizumab or panitumumab/cetuximab was conducted at the department of medical oncology of Hassan II University Hospital of Fez, Morocco, over a period of 4 years (June 2015 to June 2019). Endpoints included overall survival (OS), progression-free survival (PFS) and overall response rate (ORR). Results: 85 patients were included: 48.2% (n = 41) received cetuximab or panitumumab and 51.7% (n = 44) received bevacizumab, in association with first-line chemotherapy. Median OS and PFS did not differ significantly between patients having received bevacizumab and cetuximab or panitumumab treatment. ORR was significantly higher with first-line treatment with EGFRi. The proportion of patients with treatment-related grade 3 or higher, adverse events was similar between treatment groups. Conclusion: Our study showed no significant difference in survival between the addition of cetuximab/panitumumab vs bevacizumab to first-line chemotherapy as initial biologic treatment in RAS-wt mCRC patients.