Abstract
Following failure of the first line of palliative oxaliplatin-based chemotherapy in advanced colorectal cancer (CRC), the 2nd line regimen - FOLFIRI - is usually used. Additional biological therapy is chosen based on the composition of the previous therapy and the drugs used in the 1st line.
If anti-EGFR antibodies are administered to a patient without a 1 st RAS mutation, bevacizumab or aflibercept (VELOR study) may be used in the 2nd line. data is available but ramucirumab (RAISE clinical trial) remains unavailable for practice. In the previous use of bevacizumab in the 1st line of palliative treatment in RAS-unmutated disease, it would be appropriate to include anti-EGFR drug in the 2nd line of treatment (however, the problem is that for cetuximab we only have data in combination with atypical 2nd line FOLFOX chemotherapy and panitumumab in the 2nd line with FOLFIRI chemotherapy only Phase II clinical trial data.
Even in these cases, however, aflibercept and anti-EGFR therapy can be transferred to 3rd line palliative therapy.