The data from this survey of 101 general oncologists (GOs) confirm what has been appreciated for many years, that for KRWT mCRC the most common first-line systemic treatment used by GOs and GI cancer investigators — including Dr Johanna Bendell — is FOLFOX/CAPOX with bevacizumab. Given that the ASCO 2014 plenary presentation of the CALGB-80405 trial showed essentially no difference between chemotherapy/bevacizumab and chemotherapy/cetuximab, this practice seems unlikely to change. However, the principal investigator of that trial, Dr Alan Venook, generally starts with FOLFIRI and incorporates an accompanying biologic only selectively.

Falcone A et al. FOLFOXIRI/bevacizumab (bev) versus FOLFIRI/bev as first-line treatment in unresectable metastatic colorectal cancer (mCRC) patients (pts): Results of the phase III TRIBE trial by GONO group. Proc ASCO 2013;Abstract LBA3505.

Giantonio BJ et al. Bevacizumab in combination with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: Results from the Eastern Cooperative Oncology Group Study E3200. J Clin Oncol 2007;25(12):1539-44. Abstract

Van Cutsem E et al. Cetuximab plus irinotecan, fluorouracil, and leucovorin as first-line treatment for metastatic colorectal cancer: Updated analysis of overall survival according to tumor KRAS and BRAF mutation status. J Clin Oncol 2011;29(15):2011-9. Abstract