Efficacy And Safety Of Cetuximab Or Bevacizumab Combined With Chemotherapy In The Treatment Of Advanced Left Semi-wild-type Colorectal Cancer

Objective: To compare and analyze the efficacy and safety of cetuximab combined with chemotherapy and bevacizumab combined with chemotherapy in the treatment of advanced left RAS wild-type colorectal cancer(CRC),and to explore the best treatment plan.Method: Retrospective analysis was performed on the case data of patients with advanced left semi-RAS wild-type CRC clearly diagnosed in the Affiliated Cancer Hospital of Xinjiang Medical University from January 2015 to January 2022.According to the different types of chemical therapy combined with targeted drugs,They were divided into group A(Cetuximab combined with EGFR)and group B(bevacizumab combined with VEGF),and the follow-up time was 12 months.Adverse reactions occurred in the course of clinical treatment between the two groups were compared.At the same time,the efficacy evaluation status(CR/PR/SD/PD),objective response rate(ORR),disease control rate(DCR)and progression-free survival(PFS)of the two groups were compared.Results: 1)This study showed that adverse reactions occurred during cetuximab plus chemotherapy(group A)versus bevacizumab plus chemotherapy(group B)in patients with advanced left semi-RAS wild-type CRC,There were no statistically significant differences in digestive tract reaction,dizziness,oral mucositis,bleeding/thrombosis,shock,cardiotoxicity,liver and kidney function and electrolyte,myelosuppression,leukopenia,thrombocytopenia,neuromuscular system correlation(fatigue,pain,hand-foot syndrome)and fever between 2 groups(P>0.05).2)Compared with group B,group A was more likely to have dermal system-related adverse reactions(especially rash)(P<0.05);3)There were no CR patients in group A and Group B,and there was no statistical significance in the efficacy evaluation(PR/SD/PD)between the two groups(P>0.05).4)There was no significant difference in median PFS between group A(7.4 months(95% confidence interval: 6.6 to 8.2)and group B(8.2 months(95%confidence interval: 6.1 to 10.3))patients with advanced left half RAS(P>0.05).Conclusions: Patients with advanced left half RAS wild-type CRC are prone to rash in the course of combined treatment with cetuximab.Clinicians should be especially vigilant when using drugs,and take effective prevention if necessary.The clinical efficacy of cetuximab and bevacizumab combined with chemotherapy in the treatment of advanced left half RAS wild-type CRC was similar to that of PFS.