Panitumumab vs Bevacizumab Added to Standard First-Line Chemotherapy and Overall Survival Among Patients With RAS Wild‑type, Left‑Sided Metastatic Colorectal Cancer

Rákkutatás · Colorectal cancer · KRAS

Adding panitumumab to standard first‑line chemotherapy significantly improves overall survival compared with bevacizumab in patients with RAS wild‑type, left‑sided metastatic colorectal cancer.

In this randomized, open‑label, phase 3 trial involving 823 chemotherapy‑naïve, RAS wild‑type, unresectable metastatic colorectal cancer patients, the addition of panitumumab versus bevacizumab to standard first‑line mFOLFOX6 chemotherapy was evaluated. In the as‑treated population (n=802), 604 patients had left‑sided tumors. Median overall survival was 37.9 months with panitumumab versus 34.3 months with bevacizumab in patients with left‑sided tumors (hazard ratio 0.82; 95% CI, 0.68‑0.99; P=0.03) and 36.2 versus 31.3 months in the overall population (HR 0.84; 95% CI, 0.72‑0.98; P=0.03). Progression‑free survival, response rates, and curative resection rates were also favorably impacted with panitumumab. Common grade 3/4 adverse events included acneiform rash and stomatitis.

Demonstrating superior overall survival with panitumumab over bevacizumab in left‑sided RAS wild‑type metastatic colorectal cancer informs first‑line treatment selection and may shift clinical practice toward anti‑EGFR therapy for this patient subset.

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