Evidence map›Paper›PMID 42269232›Full record

ArticleESMO open2026

Anti-EGFR-based maintenance versus stop and go in patients with left-sided, non-MSI-H, RAS/BRAF-wt metastatic colorectal cancer: individual patient data pooled analysis.

A Raimondi, G Tinè, V Boige, A De Stefano, A Ballhausen, S Gourgou, F Giuliani, A Stahler, G Randon, M Prisciandaro and 13 more

Abstract read
In one paragraph

Article in ESMO open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

A RaimondiDepartment of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
G TinèBiostatistics for Clinical Research, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
V BoigeDepartment of Oncologic Medicine, Gustave-Roussy, Villejuif Cedex, France.
A De StefanoExperimental Clinical Abdominal Oncology Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Napoli, Italy.
A BallhausenDepartment of Hematology, Oncology, and Cancer Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
S GourgouBiometrics Unit, Cancer Institute of Montpellier, Montpellier, France.
F GiulianiMedical Oncology IRCCS Giovanni Paolo II Bari and Medical Oncology San Paolo Hospital ASL, Bari, Italy.
A StahlerDepartment of Hematology, Oncology, and Cancer Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
G RandonDepartment of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
M PrisciandaroDepartment of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
P MancaDepartment of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
M AmbrosiniDepartment of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
R FazioDepartment of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
S MohamedDepartment of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
G GronchiDepartment of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
G SantabarbaraOncology Unit, San Giuseppe Moscati Hospital, Avellino, Italy.
E BrumentUCGI, Prodige Intergroup, UNICANCER, Paris, France.
A H S AligDepartment of Hematology, Oncology, and Cancer Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
R MiceliBiostatistics for Clinical Research, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
O BoucheDepartment of Digestive Oncology, CHU Reims, Reims, France.
D P ModestDepartment of Hematology, Oncology, and Cancer Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
A AvalloneExperimental Clinical Abdominal Oncology Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Napoli, Italy.
F PietrantonioDepartment of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. Electronic address: filippo.pietrantonio@istitutotumori.mi.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDoublet chemotherapy plus an anti- epidermal growth factor receptor (EGFR) agent is a standard of care in patients with left-sided, microsatellite stable, RAS/BRAF wild-type (wt) mCRC. No conclusive evidence is available to guide treatment de-escalation, but several randomized clinical trials investigated either maintenance or intermittent treatment schedules (stop and go). PATIENTS AND

methodsWe performed an individual patient data pooled analysis of four multicenter, randomized phase II trials (PanaMa, Valentino, PRODIGE-28 TIME, IMPROVE). Only patients with left-sided, non-microsatellite instability-high, RAS/BRAFV600E-wt who started the protocol-planned post-induction treatment were included and stratified into three treatment groups: maintenance with 5-fluorouracil/leucovorin (5-FU/LV) plus anti-EGFR, maintenance with anti-EGFR alone, or stop and go. The primary endpoint was overall survival (OS) with stop and go versus 5-FU/LV plus anti-EGFR maintenance. Secondary endpoints were progression-free survival (PFS) and time to failure of strategy (TFS) with stop and go versus 5-FU/LV plus anti-EGFR; and OS, PFS, and TFS with stop and go versus anti-EGFR alone.

resultsA total of 378 molecularly selected left-sided patients were included. Overall, 166, 109, and 103 patients received maintenance with 5-FU/LV plus anti-EGFR, anti-EGFR alone, or stop and go, respectively. No significant differences in OS were reported between stop and go versus 5-FU/LV plus anti-EGFR maintenance [median 26.3 versus 29.7 months, hazard ratio (HR) 1.24, P = 0.530], or stop and go compared with anti-EGFR alone (median 26.3 versus 30.1 months, HR 1.39, P = 0.165). PFS was significantly shorter with stop and go, while TFS was comparable between stop and go compared with both maintenance schedules.

conclusionsThis pooled analysis of candidates considered optimal for initial anti-EGFR-based therapy supports both stop and go and maintenance as de-intensification strategies to consider in shared decision making. Adequately powered phase III studies are advocated to compare the two strategies.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsColorectal NeoplasmsAgedErbB ReceptorsFemaleFluorouracilHumansLeucovorinMaleMiddle AgedProto-Oncogene Proteins B-rafRandomized Controlled Trials as TopicTreatment InterruptionBRAF protein, humanEGFR protein, humanErbB ReceptorsFluorouracilLeucovorinProto-Oncogene Proteins B-rafanti-EGFR therapyintermittent treatmentmaintenance treatmentmeta-analysismetastatic colorectal cancer

Identifiers

PMID42269232
PMCPMC13273794

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.