Evidence map›Paper›PMID 42360560›Full record

ArticleJournal of gastrointestinal cancer2026

Clinical Outcomes of Second-Line FOLFIRI Plus Ramucirumab According to Prior Biologic Exposure in Metastatic Colorectal Cancer: A Retrospective Comparison of Prior Bevacizumab and Prior Anti-EGFR Cohorts.

Tamotsu Sagawa, Masahiro Hirakawa, Shutaro Oiwa, Atsushi Uesugi, Makoto Yoshida, Hiroyuki Nagashima, Koshi Fujikawa

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Journal of gastrointestinal cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Tamotsu SagawaDepartment of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, 3-54 Kikusui 4-jo 2-chome, Shiroishi-ku, Sapporo-shi, Hokkaido, 003-0804, Japan. stamotsu@jk9.so-net.ne.jp.
Masahiro HirakawaDivision of Medical Oncology, Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
Shutaro OiwaDepartment of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, 3-54 Kikusui 4-jo 2-chome, Shiroishi-ku, Sapporo-shi, Hokkaido, 003-0804, Japan.
Atsushi UesugiDepartment of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, 3-54 Kikusui 4-jo 2-chome, Shiroishi-ku, Sapporo-shi, Hokkaido, 003-0804, Japan.
Makoto YoshidaDepartment of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, 3-54 Kikusui 4-jo 2-chome, Shiroishi-ku, Sapporo-shi, Hokkaido, 003-0804, Japan.
Hiroyuki NagashimaDepartment of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, 3-54 Kikusui 4-jo 2-chome, Shiroishi-ku, Sapporo-shi, Hokkaido, 003-0804, Japan.
Koshi FujikawaDepartment of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, 3-54 Kikusui 4-jo 2-chome, Shiroishi-ku, Sapporo-shi, Hokkaido, 003-0804, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRamucirumab plus FOLFIRI is an established second-line treatment option for metastatic colorectal cancer (mCRC) after oxaliplatin-based first-line therapy. However, real-world data comparing outcomes according to prior biologic exposure are limited.

methodsWe retrospectively reviewed patients with mCRC who received second-line FOLFIRI plus ramucirumab after oxaliplatin- and fluoropyrimidine-based first-line therapy combined with either bevacizumab or an anti-EGFR antibody. Efficacy, safety, and subsequent treatment patterns were evaluated.

resultsAmong 135 screened patients, 85 were included: 55 in the prior bevacizumab group and 30 in the prior anti-EGFR group. The prior anti-EGFR group was enriched for RAS wild-type tumors (100.0% vs. 12.7%) and left-sided primary tumors (90.0% vs. 58.2%). The objective response rate was 9.1% versus 33.3%, median progression-free survival was 6.1 versus 7.9 months, and median overall survival was 19.8 months (95% CI, 14.0-27.5) versus 31.5 months (95% CI, 11.0-37.8), respectively. Adverse events were manageable in both groups, without a marked increase in severe proteinuria in the prior bevacizumab group.

conclusionSecond-line FOLFIRI plus ramucirumab showed clinically meaningful activity and manageable toxicity after either prior biologic strategy. The more favorable outcomes observed in the prior anti-EGFR cohort should be interpreted as hypothesis-generating because of baseline biologic imbalance and potential confounding.

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsCamptothecinColorectal NeoplasmsAdultAgedAged, 80 and overBevacizumabErbB ReceptorsFemaleFluorouracilHumansLeucovorinMaleMiddle AgedProgression-Free SurvivalAntibodies, Monoclonal, HumanizedBevacizumabCamptothecinEGFR protein, humanErbB ReceptorsFluorouracilLeucovorinRamucirumabAnti-EGFR antibodyBevacizumabFOLFIRIMetastatic colorectal cancerRamucirumabReal-world study

Identifiers

PMID42360560

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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.