Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Mar 24, 2025; 16(3): 102076
Published online Mar 24, 2025. doi: 10.5306/wjco.v16.i3.102076
Overall survival with frontline vs subsequent anti-epidermal growth factor receptor therapies in unresectable, RAS/BRAF wild-type, left-sided metastatic colorectal cancer
Nussara Pakvisal, Richard M Goldberg, Chirawadee Sathitruangsak, Witthaya Silaphong, Satawat Faengmon, Nattaya Teeyapun, Chinachote Teerapakpinyo, Suebpong Tanasanvimon
Nussara Pakvisal, Witthaya Silaphong, Satawat Faengmon, Nattaya Teeyapun, Suebpong Tanasanvimon, Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and The King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
Richard M Goldberg, Department of Medicine, WVU Cancer Institute, West Virginia University, Morgantown, WV 26506, United States
Chirawadee Sathitruangsak, Medical Oncology Unit, Division of Internal Medicine, Faculty of Medicine, Holistic Center for Cancer Study and Care (HOCC-PSU) and Prince of Songkla University, Songkhla 90110, Thailand
Chinachote Teerapakpinyo, Chulalongkorn GenePRO Center, Research Affairs, Chulalongkorn University and The King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
Author contributions: Pakvisal N, Goldberg RM, Sathitruangsak C and Tanasanvimon S conceived and designed the study; Pakvisal N, Sathitruangsak C, Silaphong W, Faengmon S, Teeyapun N and Teerapakpinyo C performed data collection; Pakvisal N performed statistical analysis; Pakvisal N, Goldberg RM and Tanasanvimon S wrote the first draft of the manuscript. All authors contributed to the data interpretation. All the authors revised and edited the final manuscript.
Institutional review board statement: This study was reviewed and approved by the International Review Board of the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (No. 0375/66).
Informed consent statement: A waiver of informed consent was granted by the Ethics Committee.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: The datasets analyzed during the study are available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Suebpong Tanasanvimon, MD, Assistant Professor, Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and The King Chulalongkorn Memorial Hospital, 1873 RAMA IV Road, Bangkok 10330, Thailand. surbpong@yahoo.com
Received: October 7, 2024
Revised: November 25, 2024
Accepted: December 12, 2024
Published online: March 24, 2025
Processing time: 105 Days and 13.2 Hours
Core Tip

Core Tip: Anti-epidermal growth factor receptor (EGFR) therapy improves survival in RAS/BRAF wild-type metastatic colorectal cancer, whether used in frontline or subsequent settings. No direct evidence demonstrates frontline treatment’s superiority, particularly in unresectable, left-sided tumors. Our study found no significant difference in overall survival between these approaches, suggesting timing does not affect overall survival if anti-EGFR therapy is administered. However, omitting frontline anti-EGFR risks some patients losing the chance to benefit later. These findings highlight the importance of early exposure and offer valuable guidance for optimizing treatment sequencing in this patient population.