In keeping with our desire to tease out the nuances of clinical decision-making, we also asked about the patient whose disease progresses after only 3 cycles of FOLFOX with bevacizumab in the first-line setting. Most of the survey respondents — and both faculty members — would switch to an EGFR antibody with irinotecan-based chemotherapy, but it is interesting that those who continue an anti-VEGF strategy most commonly use bevacizumab rather than aflibercept.

Venook AP et al. CALGB/SWOG 80405: Phase III trial of irinotecan/5-FU/leucovorin (FOLFIRI) or oxaliplatin/5-FU/leucovorin (mFOLFOX6) with bevacizumab (BV) or cetuximab (CET) for patients (pts) with KRAS wild-type (wt) untreated metastatic adenocarcinoma of the colon or rectum (MCRC). Proc ASCO 2014;Abstract LBA3.

Stein A et al. The role of peri-operative treatment in resectable liver metastases of colorectal cancer. Ther Adv Med Oncol 2010;2(6):389-98. Abstract