Antiangiogenic match-off.

June 23, 2017. A large phase 3 trial published this week in JAMA shows no difference in median survival with the use of cetuximab (30 months) vs bevacizumab (29 months) in combo with chemo for advanced and/or metastatic KRAS wt colorectal cancer. 1137 patients previously untreated for advanced or metastatic disease were randomized to upfront cetuximab (anti-EGFR) or bevacizumab (anti-VEGF) in combo with physician’s choice of 5FU-based chemo with mFOLFOX6 (includes oxaliplatin) or FOLOFIRI (includes irinotecan). So what’s the take-away? Interestingly, both groups did considerably better than the predicted median overall survival of 22 months used for the power analysis. Possible explanations include the increased utilization of tumor-directed therapies in oligometastatic disease as well as exclusion of KRAS mutant patients. In this contest, both sides win.


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