Why carry out this study?

Second-line antiangiogenic drugs in combination with chemotherapy are recommended for patients with RAS wild-type colorectal cancer (CRC) who have previously received first-line anti-epidermal growth factor receptor (EGFR) antibody therapy, but little evidence is available on the most appropriate second- and third-line treatment sequences for these patients.

This study assessed real-world treatment sequences, treatment duration, and clinical characteristics of Japanese patients who received first-line FOLFOX in combination with anti-EGFR antibody therapy, followed by second-line irinotecan-based chemotherapy in combination with antiangiogenic drugs, and explored the factors associated with treatment sequences and durations from second-line therapy.

What was learned from the study?

Treatment durations from second-line therapy after first-line anti-EGFR therapy were similar for patients who had received each second-line antiangiogenic drug (bevacizumab, ramucirumab, and aflibercept beta).

Factors positively associated with treatment duration from second-line therapy were duration of first-line therapy, CRC surgery before starting first-line therapy, and liver surgery during first-line therapy; negative factors associated with treatment duration were related to patient health status.

This study provides real-world evidence on the use of antiangiogenic drugs, including the newer drugs ramucirumab and aflibercept beta for patients with RAS wild-type CRC following first-line treatment with an anti-EGFR antibody.