{
  "abstract": "Background: Doublet chemotherapy plus anti–epidermal growth factor receptor (EGFR) is a standard of care in left-sided, microsatellite stable RAS and BRAF wild-type metastatic colorectal cancer. Guidelines recommend treatment de-escalation after achieving disease control with induction. Maintenance and intermittent strategies were investigated but not directly compared.\n\nMethods: We performed an individual patient data pooled analysis of 3 randomized phase II trials (PanaMa, Valentino, PRODIGE-28 TIME) focused on toxicity analysis. Only patients with left-sided, nonmicrosatellite instability high RAS and BRAF V600E wild type who started protocol-planned postinduction were included and stratified into 3 treatment groups: 5-fluorouracil and leucovorin plus anti-EGFR maintenance, anti-EGFR alone, or intermittent. Longitudinal toxicity data were collected and analyzed according to literature-based approach (toxicity over time), incorporating dimension of time into adverse event assessment and analyzing individual and groups of adverse events comparing treatment groups.\n\nResults: Overall, 327 patients were included: 166, 109, and 52 patients received anti-EGFR plus 5-fluorouracil and leucovorin maintenance, anti-EGFR alone, and intermittent strategy, respectively. Mean adverse event grades for chemotherapy-related toxicity showed different longitudinal patterns. Mean grades in intermittent strategy were lower in early cycles and increased later, and higher values were reported for combination maintenance. Considering anti-EGFR–related skin toxicity, the mean adverse event grade was constantly lower for intermittent strategy compared with maintenance groups. Overall, grades 3 and 4 adverse events were more represented in maintenance groups vs intermittent strategy, although the predominant grade was 1 across cycles for all groups.\n\nConclusions: In our individual patient data analysis, indirectly comparing 3 clinical trials, intermittent strategy showed lower anti-EGFR skin-related toxicity vs maintenance. Shared decision making, considering patient and tumor features and treatment tolerability, may allow defining optimal de-intensification strategy.+*+9",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 19,
  "authors": [
    {
      "name": "Alessandra Raimondi"
    },
    {
      "name": "Gabriele Tinè"
    },
    {
      "name": "Valerie Boige"
    },
    {
      "name": "Alexej Ballhausen"
    },
    {
      "name": "Sophie Gourgou"
    },
    {
      "name": "Arndt Stahler"
    },
    {
      "name": "Giovanni Randon"
    },
    {
      "name": "Paolo Manca",
      "orcid": "0000-0002-3813-6339"
    },
    {
      "name": "Emilie Brument"
    },
    {
      "name": "Annabel Helga Sophie Alig"
    },
    {
      "name": "Federica Morano",
      "orcid": "0000-0002-5306-3596"
    },
    {
      "name": "Michele Prisciandaro"
    },
    {
      "name": "Margherita Ambrosini",
      "orcid": "0000-0003-4131-2409"
    },
    {
      "name": "Roberta Fazio"
    },
    {
      "name": "Yiyi Zhu"
    },
    {
      "name": "Rosalba Miceli",
      "orcid": "0000-0003-0954-375X"
    },
    {
      "name": "Olivier Bouche"
    },
    {
      "name": "Dominik Paul Modest",
      "orcid": "0000-0002-6853-0599"
    },
    {
      "name": "Filippo Pietrantonio",
      "orcid": "0000-0002-8530-8420"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7fd85qgvw03e2.bib",
  "cited_by": 0,
  "doi": "10.1093/jnci/djag160",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13748732/",
  "id": "7fd85qgvw03e2",
  "issns": [
    "0027-8874",
    "1460-2105"
  ],
  "landing_url": "https://doi.org/10.1093/jnci/djag160",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00010"
    ],
    [
      "heading",
      "Article"
    ],
    [
      "openalex",
      "2730|Colorectal Cancer Treatments and Studies"
    ]
  ],
  "openalex": "W7162326477",
  "pdf_url": null,
  "pmcid": "PMC13748732",
  "pmid": "42178223",
  "published": "2026-05-22",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/7fd85qgvw03e2.ris",
  "sources": [
    {
      "first_seen": "2026-11-13T12:26:50Z",
      "native_id": "PMC13748732",
      "source": "pmc",
      "url": "https://doi.org/10.1093/jnci/djag160"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Colorectal Cancer Treatments and Studies",
      "subfield": "oncology"
    }
  ],
  "title": "Toxicity-over-time analysis of anti–epidermal growth factor receptor–based maintenance vs intermittent in left-sided RAS and BRAF wild-type metastatic colorectal cancer",
  "title_text": "Toxicity-over-time analysis of anti–epidermal growth factor receptor–based maintenance vs intermittent in left-sided RAS and BRAF wild-type metastatic colorectal cancer",
  "type": "peer-reviewed",
  "updated_at": "2026-11-13T12:26:50Z",
  "url": "https://research.draconitic.com/paper/7fd85qgvw03e2",
  "venue": "JNCI Journal of the National Cancer Institute",
  "versions": []
}