Bevacizumab or standard chemotherapy in previously treated patients with metastatic colorectal cancer — a systematic review

Introduction. The BRAF V600E mutation ( mt) occurring in the metastatic colorectal cancer (mCRC) patients is associated with poorer prognosis, comparison to wild-type variant of gene wt). Aim of this work was assess clinical efficacy bevacizumab (BEVA) or standard chemotherapy (ChT) 2nd or further lines treatment mCRC mt population.  Material and methods. MEDLINE/PubMed, Embase Cochrane CENTRAL databases were systematically searched. reference lists relevant studies also checked.  Results. 6 eligible trials identified: MOMA (BEVA ± ChT), allowing for limited overall survival (OS) assessment, WJOG 6210G + FOLFIRI), RAISE 20050181 (FOLFIRI), PICCOLO Spindler 2013 (irinotecan monotherapy). None those designed evaluation population. Available evidence restricted analyses small subgroups (from a few several dozens patients), occasionally comprising RAS as well. Based on identified studies, of BEVA ChT vs. among different ChTs population not feasible. In case BEVA (MOMA), OS hazard ratio (HR) wt 1.52 (95% CI: 0.79–2.89) difference in medians equal 12.1 months (19.2 31.3 months, respectivelly), patients had median lower by 7.9 progression free (PFS) 3.0 WJOG 6210G trial. In ChT, PFS 12–67% (HRs range: 1.01–5.3), by 34–73% 1.05–5.00).  Conclusions. Due evidence, assessment uncertain, however existing data consistently suggest effectiveness mt, than subgroup. Hopefully, combining anti-EGFR therapies BRAF/MEK inhibitor is expected to improve prognosis patients.