What would be your chemotherapy/biologic sequence choice in a RAS wildtype metastatic CRC, for which FOLFOX and bevacizumab was given first line?

In second line RAS WT patients who have not had anti-EGFR and have not had irinotecan, anti-EGFR therapy with either irinotecan monotherapy or with 5-FU. There is no prospective data that supports using sidedness to withhold anti-EGFR for right sided patients who are RAS WT.

References for 2nd line c...

Multiple factors would go into my decision re second line therapy. I agree with @Dr. First Last in his answer above that I would not give anti-EGFR therapy to a right sided colon cancer, though I agree this has not been prospectively studied. The strongest evidence to my knowledge of the predictive ...

There are multiple post-hoc analyses of randomized, prospective studies that have shown that a right-sided primary tumor location is predictive of a lack of a survival benefit from EGFR inhibitors, vs use of bevacizumab (see this meta-analysis from Holch et al). Admittedly the data referenced here a...

I agree. I guess it’s more in the 3rd line. I do chemo alone in 2nd line +/- continuing bev (assuming no other biomarkers) but in 3rd line, pending clinical situations, I don't discount 3rd line anti-EGFR in a right sided patient. I still do find myself looking for trials in 3rd line, often before a...