ArticleInternational journal of clinical oncology2026
Efficacy and safety of second-line fluorouracil, leucovorin, and irinotecan plus ramucirumab according to prior first-line regimens in metastatic colorectal cancer: a multicenter retrospective study.
Article in International journal of clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFluorouracil, leucovorin, and irinotecan (FOLFIRI) plus ramucirumab is a well-established second-line treatment for metastatic colorectal cancer (mCRC) following bevacizumab-based chemotherapy. However, its efficacy after other first-line regimens, including anti-EGFR antibody-based and triplet chemotherapy, remains insufficiently characterized. The aim of this study was to compare the efficacy and safety of FOLFIRI plus ramucirumab between patients treated with different first-line treatment regimens.
methodsThis retrospective multicenter study included 186 mCRC patients who received second-line FOLFIRI plus ramucirumab between 2016-2025. Patients were classified into three groups based on their first-line regimens: Bmab (bevacizumab-based), EGFR (anti-EGFR antibody-based), and Triplet (triplet chemotherapy). The primary endpoint was progression-free survival (PFS). Survival outcomes were evaluated using the Kaplan-Meier method and a propensity score-stratified Cox proportional hazards model.
resultsThe incidence of grade ≥ 3 adverse events, the median PFS and overall survival (OS) in the Bmab, EGFR, and Triplet groups were comparable (adverse events; 33.8%, 33.3%, 37.3%; PFS: 8.2, 8.6, and 8.7 months; and OS: 18.9, 23.0, and 17.8 months, respectively). In the propensity score-adjusted model using the Bmab group as the reference, no evidence of a difference was detected in PFS (adjusted hazard ratio [95% CI]: 1.84 [0.88-3.83] and 0.97 [0.66-1.45] in the EGFR and Triplet groups, respectively) or OS (1.26 [0.64-2.47] and 0.84 [0.55-1.29] in the EGFR and Triplet groups, respectively).
conclusionsIn this retrospective real-world cohort, FOLFIRI plus ramucirumab appeared feasible after anti-EGFR antibody-based or triplet chemotherapy, with no clear signal of markedly different outcomes across prior first-line regimens.
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