Authors
Olesya Kuznetsova, Elena Battaiotto, Giulia Malvezzi, Lorenzo Gervaso, Maria Giulia Zampino, Chiara Alessandra Cella, Lavinia Benini, Francesca Spada, Mikhail Fedyanin, Alexey Tryakin, Fabio Carbone, Brigida Anna Maiorano, Davide Ciardiello, Nicola Fazio
Published in
Critical reviews in oncology/hematology. Pages 105180. Feb 04, 2026. Epub Feb 04, 2026.
Abstract
Anti-EGFR rechallenge emerged as a potential therapeutic option for patients with chemorefractory metastatic colorectal cancer (mCRC) that maintained a circulating tumor DNA (ctDNA) RAS/BRAF wild type (WT) status. However, its efficacy compared to standard of care (SoC) in randomized controlled trials (RCTs) remains uncertain. In our systematic review and meta-analysis, we investigated the outcomes of anti-EGFR rechallenge versus SoC for patients with pretreated ctDNA RAS/BRAF WT mCRC. This study followed the PRISMA guidelines, and a systematic search of PubMed and ASCO/ESMO meeting abstracts was conducted in October 2025 for relevant RCTs. Pooled odds ratios (OR) for disease control rate (DCR) and objective response rate (ORR), and hazard ratios (HR) for survival outcomes were calculated. We identified three phase II randomized trials with 320 patients. Anti-EGFR rechallenge significantly improved DCR (OR = 3.39, 95% CI 2.13 - 5.39), ORR (OR = 5.13, 95% CI 2.30 - 11.41) and progression free survival (HR 0.674; 95% CI, 0.499 - 0.909; p=0.009) compared to SoC. No overall survival benefit was detected (HR 0.895; 95% CI 0.736 - 1.087; p = 0.263). These findings support the use of anti-EGFR rechallenge strategy aslater-line treatment when tumor shrinkage is a clinical priority. Further evidence from prospective trials is required.
PMID:
41651313
Bibliographic data and abstract were imported from PubMed on 07 Feb 2026.
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