Targeted therapy in first line treatment of RAS wild type colorectal cancer

The debate on the optimal drug combination for treating chemotherapy-naïve patients with metastatic colorectal cancer has recently become particularly heated. The present editorial will review recent data on this topic. The FIRE-3 and PEAK trials have shown a 7.5 to 12 mo survival advantage with the use anti-epidermal growth factor receptor (anti-EGFR) antibodies. The CALGB 80405 has shown no difference between anti-EGFR and anti-vascular endothelial growth factor agents. All three trials have consistently shown a significant increase in objective response rate. These data suggest that there is a subset of metastatic colorectal cancer patients, rigorously selected by molecular profiling, who particularly benefit from an anti-EGFR-based regimen in the first-line setting.