{"entity":{"id":"anti-egfr-left-sided","kind":"pairing","name":"Anti-EGFR antibody + chemotherapy in left-sided RAS/BRAF wild-type mCRC","aka":[],"tldr":"In bowel cancers that start on the left and have normal RAS and BRAF genes, adding an EGFR antibody to chemotherapy gives the longest survival seen in first-line trials.","summary":"PARADIGM: OS 37.9 months with panitumumab + mFOLFOX6 in left-sided RAS wild-type disease. FIRE-3 and CALGB 80405 subgroups agree. Right-sided or RAS/BRAF-mutant tumours should get bevacizumab instead. Anti-EGFR rechallenge after a chemotherapy-free interval, guided by ctDNA showing RAS/EGFR clones have receded (CHRONOS), is an emerging strategy.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT02394795: PARADIGM","url":"https://clinicaltrials.gov/study/NCT02394795"}],"tags":[],"related":[],"cancers":["colorectal"],"sections":[],"technologies":[],"targets":[],"drugs":["panitumumab","cetuximab","folfox","folfiri"],"companies":[],"institutions":[],"pathways":[],"terms":["sidedness"],"trials":["paradigm","crystal-fire3"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"panitumumab","b":"folfox","rationale":"Left-sided tumours are EGFR-ligand dependent and RAS wild-type; right-sided tumours carry BRAF, dMMR, and other resistance biology.","evidence":"Phase 3 (PARADIGM) with OS benefit; multiple consistent retrospective analyses.","pairingType":"combination"},"route":"/pairings/anti-egfr-left-sided/","neighbours":{"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"}],"drug":[{"id":"cetuximab","kind":"drug","name":"Cetuximab","route":"/drugs/cetuximab/"},{"id":"folfiri","kind":"drug","name":"FOLFIRI (5-FU, leucovorin, irinotecan)","route":"/drugs/folfiri/"},{"id":"folfox","kind":"drug","name":"FOLFOX (5-FU, leucovorin, oxaliplatin)","route":"/drugs/folfox/"},{"id":"panitumumab","kind":"drug","name":"Panitumumab","route":"/drugs/panitumumab/"}],"term":[{"id":"sidedness","kind":"term","name":"Sidedness (left vs right colon)","route":"/terms/sidedness/"}],"trial":[{"id":"crystal-fire3","kind":"trial","name":"CRYSTAL & FIRE-3","route":"/trials/crystal-fire3/"},{"id":"paradigm","kind":"trial","name":"PARADIGM","route":"/trials/paradigm/"}],"roadmap":[{"id":"colorectal-roadmap","kind":"roadmap","name":"Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation","route":"/roadmaps/colorectal-roadmap/"}]}}