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Will you give perioperative chemotherapy with EGFR inhibitors for stage IV left-sided RAS/BRAF WT colorectal cancer with resectable/borderline resectable liver metastases given discordant PARADIGM vs New EPOC trial results?

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Mednet Member
Mednet Member
Medical Oncology · Mayo Clinic

This is a very controversial topic/discussion.

The New EPOC study was a multicenter, open label, randomized phase 3 study that enrolled 257 patients with KRAS wild-type resectable or suboptimally resectable colorectal liver metastatic disease. Patients were randomized to systemic chemotherapy with or...

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Mednet Member
Mednet Member
Medical Oncology · Mayo Clinic

No. I don't give perioperative EGFRi when patients have oligometastatic CRC to the liver. New EPOC and other smaller noncomparative reports of worse outcomes following metastasectomy when exposed preoperatively to EGFRi, despite better initial responses when combining chemo with EGFRi (as in, median...

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Medical Oncology · Mary Lanning Healthcare Morrison Cancer Center/University of Nebraska Medical Center Adjunct Faculty

Tumor subsite seems to influence the treatment choices in patients with wild-type RAS colorectal cancer with benefits seen from anti-EGFR therapy primarily in those with left-sided or distal tumors. A pooled analysis of 5 randomized first-line trials (FIRE-3, CRYSTAL, PRIME, PEAK, and CALGB/SWOG 804...

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