Using the Morbidity and Mortality Conference Model to Explore and Improve Community-Based Oncology Care (Video Program)Use of anti-EGFR antibodies for RAS wild-type mCRC and impact of primary tumor location on the efficacy of anti-EGFR therapy
2:00 minutes.
TRANSCRIPTION:
DR HECHT: I am somewhat biased because I’ve been working with these drugs since before they were approved. And what I would say is that it is harder for the patient but is almost always tolerable. It’s also harder for the physicians. And so bevacizumab, from the oncologist’s standpoint, it’s a lot easier. You don’t have to talk about doxycycline or steroids. You don’t have to come in and have the patient talk to you, complain about these things. That being said, in other parts of the world, actually, anti-EGFR therapies, like in Europe, are really very standard front line. And, in fact, they’re becoming a larger percentage. The Europeans have been saying that we underuse these drugs for a long time. It’ll be interesting to see what happens with that as that is looked at and digested and thought about. DR LOVE: But one side doesn’t supposedly respond to EGFR antibodies. Which side is it? DR HECHT: It’d be the right side, seems to have less, but that’s the minority of patients. Remember, most patients have left-sided disease. So the difference was, on the right side, a very large difference. There was a smaller difference on the left side, but it looked a little bit better — retrospective data, but consistent retrospective data. The FIRE-3 trial from Europe, which was a FOLFIRI backbone, also looked very similar. And people have been talking about this for a while. So eventually it’ll be like the neurology. They talk about right-handed. We’ll be talking about right-sided and left-sided. DR LOVE: Are we moving towards really dividing the disease up into right and left side? Do you think the trials are going to do that? DR HECHT: Right now, first of all, even when you look at that data, it’s probably not sidedness, per se, but — since you’re talking about biomarkers — there are probably other biomarkers that are in there. And I think that, at least for now, we’re using sidedness as a surrogate for those markers. But hopefully in the future we’ll be able to be a little bit smarter. But I think, actually, we will be. |