Published online Nov 15, 2019. doi: 10.4251/wjgo.v11.i11.1031
Peer-review started: June 6, 2019
First decision: August 23, 2019
Revised: September 7, 2019
Accepted: September 13, 2019
Article in press: September 13, 2019
Published online: November 15, 2019
Processing time: 164 Days and 14.9 Hours
Although cetuximab is shown to provide survival benefits in patients with RAS wild-type metastatic colorectal cancer, little is known about the optimal chemotherapy backbone for cetuximab except that oral fluoropyrimidine appeared to be inferior to infusional fluoropyrimidine and is not recommended in various international guidelines.
Before the evidence of the inferiority of oral fluoropyrimidine combining with cetuximab, it was commonly used due to convenience and cost effectiveness. The inferiority of oral fluoropyrimidine was not readily observed in our previous experience. In addition, research has shown that there might be a regional difference in the tolerability of oral fluopyrimidine. The inferiority of oral fluopyrimidine demonstrated in previous studies might not be applicable to our locality with Chinese population.
This study would like to compare oral fluoropyrimidine with infusional fluoropyrimidine in combination with cetuximab in Chinese population in terms of progression-free survival and overall survival.
A retrospective cohort study was employed to compare and contrast the survival and adverse effect profile of oral fluoropyrimidine (FP) and infusional FP in combination with cetuximab in Chinese population in the real-world setting.
There was no significant difference in median progression-free survival and median overall survival between the two groups. The incidence of various grade 3 or above adverse effects was similar in both groups.
Oral and infusional fluoropyrimidine has comparable efficacy and safety profiles when used with cetuximab.
Oral fluoropyrimidine may be a good alternative to infusional fluoropyrimidine when in combination with cetuximab.