Latest developments in the treatment of metastatic colorectal cancer: update ASCO 2014

Studies presented on metastatic colorectal cancer at this year’s ASCO focused on RAS as a predictive biomarker for anti-epidermal growth factor receptor (EGFR)-directed therapies. Extended RAS analysis for the CRYSTAL study were presented for the first time and showed improved benefit in terms of overall survival, progression-free survival and response rate within the all RAS wild-type cohort. Together we already known results from other anti-EGFR-directed studies it can be stated that expanded RAS status assessment is a prerequisite for the use of an anti-EGFR antibody. The German AIO group showed results of their maintenance study AIO-0207 contributing to the body of evidence of maintenance therapy. The current evidence from two phase-III studies suggests that maintenance therapy with capecitabine plus bevacizumab is a valid option after induction therapy. Eagerly awaited were the first results of the CALGB80405-trial using either bevacizumab or cetuximab in combination with first-line chemotherapy. No difference in OS could be observed between the two treatment arms in KRAS wild-type patients.