There is growing agreement with Dr. Falcone—based on limited data—that response rates appear to be increased with FOLFOX plus cetuximab, as compared with FOLFOX alone, for KRAS wild-type patients only, according to Jordan Berlin, MD, associate professor of medicine and clinical director of GI oncology at Vanderbilt University in Nashville.
“We do not have data, on the other hand, that definitively show higher response rates with chemotherapy plus bevacizumab,” Dr. Berlin pointed out. “Therefore, if the goal is to convert patients from unresectable to resectable status, the available data suggest that cetuximab accomplishes this. We must acknowledge, however, that the data are still very limited and resectability has not been the primary endpoint of any study.”
Dr. Berlin also noted that cetuximab has not been associated with wound healing problems, which is a concern with bevacizumab, though recent findings have been more reassuring.
Since current data have been “extracted” from trials and are not the result of randomization, “to say that one agent is definitely better than the other is standing on shaky ground.”
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