Would you consider the use of EGFR inhibition (cetuximab/panitumumab) in first line in metastatic right-sided RAS/RAF WT colon cancer, if bevacizumab contraindicated?

This is an area where I’ve seen practice patterns diverge amongst practitioners, even within the same institute, and has been subject to some lengthy discussions within our tumor boards.

For me, the short answer is that in general, no, I would not give anti-EGFR to a patient with a right-sided tumor...

The use of EGFR inhibitors here might depend on what the goal is.

Is the goal conversion therapy to render someone resectable? And/or need for response?

I’d also like to know if the contra-indication to BEV is relative versus absolute.

There’s biological rationale in someone truly RAS/RAF wildtype (...

Studies in this setting are retrospective and metanalysis type in nature. I am not convinced that right-sided tumors do not benefit especially if RAS wild-type. Studies including CALGB/SWOG 80405, CRYSTAL and FIRE-3, have shown that among patients with KRAS wt untreated advanced or metastatic colore...