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Updated: Jan 30, 2026

Isolation of Human Endothelial Cells from Normal Colon and Colorectal Carcinoma - An Improved Protocol
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Published on: April 4, 2018

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Sequential therapy with bevacizumab and EGFR inhibitors for metastatic colorectal carcinoma: a national

Tomas Buchler1, Renata Chloupkova2, Alexandr Poprach3

  • 1Department of Oncology, First Faculty of Medicine, Charles University and Thomayer University Hospital, 140 59 Prague, Czech Republic, tomas.buchler@ftn.cz.

Cancer Management and Research
|January 16, 2019
PubMed
Abstract

Insights

For metastatic colorectal cancer (mCRC) with wild-type KRAS, sequencing bevacizumab before epidermal growth factor receptor inhibitors (EGFRi) showed similar overall survival but improved progression-free survival compared to the reverse order.

Area of Science:

  • Oncology
  • Medical Oncology
  • Gastrointestinal Oncology

Background:

  • Metastatic colorectal cancer (mCRC) treatment commonly involves vascular endothelial growth factor inhibitors and epidermal growth factor receptor inhibitors (EGFRi).
  • Optimal sequencing of these agents in mCRC remains an area of clinical uncertainty.

Purpose of the Study:

  • To compare overall survival (OS) and progression-free survival (PFS) in mCRC patients with wild-type KRAS exon 2.
  • To evaluate outcomes based on the sequence of bevacizumab and EGFRi (cetuximab or panitumumab) in first- and second-line therapy.

Main Methods:

  • Retrospective analysis of a national registry of targeted therapies.
  • Inclusion of 490 patients with mCRC and wild-type KRAS exon 2 status.
  • Comparison of bevacizumab → EGFRi sequence versus EGFRi → bevacizumab sequence.

Main Results:

  • Median OS was similar between the bevacizumab → EGFRi (31.4 months) and EGFRi → bevacizumab (31.8 months) sequences.
  • Median PFS favored the bevacizumab → EGFRi sequence (21.1 months) over the EGFRi → bevacizumab sequence (19.3 months).
  • The difference in PFS was statistically significant (P=0.016).

Conclusions:

  • In patients with wild-type KRAS exon 2 mCRC, no significant difference in OS was observed between the two treatment sequences.
  • The bevacizumab → EGFRi sequence demonstrated a statistically significant improvement in combined PFS.
  • Real-world data suggests a potential benefit for initiating bevacizumab before EGFRi in this patient population.
Keywords:
bevacizumabcetuximabcolorectal carcinomapanitumumabsequence

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