Abstract
Following a failure of the first line of palliative oxaliplatin-based chemotherapy in a patient with advanced colorectal cancer, FOLFIRI regimen is mostly used. Adjunctive Biological Treatment is selected according to previous line 1 therapy - with prior use of anti-EGFR antibodies in patients with wild type (WT) RAS genes, bevacizumab or aflibercept (VELOUR clinical trial) or racemicramab RAISE clinical trial).
When using bevacizumab in a patient with WT RAS, an anti-EGFR medication should be administered in the 2nd line (but the problem is that for cetuximab data are not quite typical of the 2nd line of FOLFOX chemotherapy and for panitumumab it was on the 2nd line data with FOLFIRI chemotherapy were obtained in a Phase II clinical trial). However, afflibercept, prospectively also ramucirumab, may be applied; anti-EGFR therapy can then be moved to the 3rd line of palliative treatment.