Second-Line Therapies in KRAS?Wild-Type mCRC
In the original FIRE 3 trial, first-line therapy with FOLFIRI plus either cetuximab or bevacizumab were compared in 592 patients with KRAS?wild-type mCRC. In a follow-on study presented as ASCO 2014, second-line therapy for these patients was evaluated, comparing FOLFOX + bevacizumab versus irinotecan + cetuximab (Modest DP, et al. ASCO 2014. Abstract 3558). Overall survival from second-line therapy was 25.2 months (anti-VEGF antibody) versus 23.7 months (anti-EGFR antibody) versus 30.8 months (no antibody), suggesting that preplanned second-line therapy based on first-line regimens may not be valid and could incur unnecessary costs.