Survival outcomes with first-line targeted therapy for metastatic colorectal cancer in routine clinical care

Guidelines recommend treating patients with metastatic colorectal cancer with first-line targeted therapies, including EGFR inhibitors and VEGF inhibitors, depending on the presence or absence of specific mutations. Since most studies of first-line targeted therapies have been limited by sample size, there is a need for larger studies using data from routine clinical care. A cohort study using data of 9134 first-line mCRC patients from 800 centers found that more than one-third of the patients received no targeted therapy. Use of EGFR inhibitors was associated with survival benefit only in patients with RAS-wild type tumors. Certain combinations of targeted therapy and chemotherapy were associated with improved survival in smaller patient subgroups. The authors conclude that given the differences between these findings and those of randomized clinical trials, this study highlights the importance of analyzing outcomes in routine clinical practice.