Evaluating the health-related quality of life outcomes of second-line chemotherapy combined with either bevacizumab or cetuximab in patients with advanced colorectal cancer.

This study evaluated the health-related quality of life (HR-QoL) outcomes of second-line chemotherapy combined with either bevacizumab (Avastin) or with cetuximab (Erbitux) in patients with advanced colorectal cancer with wild-type KRAS. This study concluded that the HR-QoL outcomes were similar with both treatments in these patients.

Metastatic colorectal cancer (mCRC) means the cancer has spread from the large intestine to other areas of the body. Genetic changes in the KRAS protein can often occur to promote mCRC growth and spread. mCRC tumors that do not have these genetic changes are known as KRAS wild-type mCRC.

FOLFOX (folinic acid, fluorouracil, oxaliplatin) and FOLFIRI (folinic acid, fluorouracil, irinotecan) chemotherapies are the recommended first-line therapies for advanced CRC. Bevacizumab and cetuximab are targeted therapies. They target certain proteins on cancer cells that promote cancer cell growth and spread, therefore stopping cancer growth. They have been shown to improve the outcomes of patients with mCRC when added to chemotherapy. 

Any treatment has the potential to have side effects that can reduce the HR-QoL of patients. The HR-QoL outcomes of second-line chemotherapy (modified FOLFOX/FOLFIRI) combined with either bevacizumab or with cetuximab in patients with advanced colorectal cancer with wild-type KRAS are still unknown.

This study involved 133 patients with mCRC. Patients had wild-type KRAS CRC and had previously failed treatment with bevacizumab. Patients were randomly assigned into 2 groups. Group 1 included 65 patients who received chemotherapy plus bevacizumab. Group 2 included 67 patients who received chemotherapy plus cetuximab. A standardized questionnaire was used to assess the HR-QoL at the start of the treatment, before tumor assessments 1 and 3, and at the end of treatment.

There were no significant differences in the HR-QoL scores between the 2 treatment groups. Diarrhea was significantly higher with bevacizumab compared to cetuximab.

This study concluded that the HR-QoL outcomes were similar with both bevacizumab and cetuximab combined with second-line chemotherapy in patients with wild-type KRAS advanced CRC.

This study included a very small number of participants. Further larger studies are needed.