The efficacy and safety of switching to bevacizumab in the first-line treatment of metastatic colorectal cancer with wild-type rat sarcoma gene

Zhang Yao; Li Yuqi; Zhao Xue; Wang Haiyan

doi:10.3760/j.issn.1673-4777.2025.10.014

Abstract：Objective To analyze the efficacy and safety of switching bevacizumab in patients with rat sarcoma(RAS)wild-type metastatic colorectal cancer(mCRC)who could not tolerate the skin toxicity of cetuximab in the first-line treatment.Methods A total of 143 patients with RAS wild-type mCRC who received two-drug chemotherapy combined with cetuximab as first-line treatment and completed at least one efficacy evaluation without disease progression in the Affiliated Hospital of Xuzhou Medical University from January 2018 to July 2023 were retrospectively selected.The observation group was the patients who could not tolerate the skin toxicity of cetuximab and switched to bevacizumab-based treatment,and the control group was the patients who could continue to receive cetuximab.The efficacy and safety of the two groups were compared.Results After propensity score matching,the median progression-free survival of the observation group and the control group were 10.5 months(95％confidence interval:9.3-11.7 months)and 10.8 months(95％confidence interval:9.4-12.2 months),respectively,and there was no significant difference between the two groups(P=0.28).The median overall survival was 27.1 months(95％confidence interval:22.9-31.3 months)and 33.5 months(95％confidence interval:25.9-4 1.0 months),respectively,and there was no significant difference between the two groups(P=0.17).During the treatment,the proportion of skin toxicity in the observation group was lower than that in the control group(P＜0.05),and there was no significant difference in the incidence of other adverse reactions between the two groups(all P＞0.05).Conclusion Switching to bevacizumab is also a treatment option for patients with RAS wild-type mCRC who cannot tolerate cetuximab skin toxicity during first-line therapy.