{
  "abstract": "Background\n\nEvidence of treatment strategies in frail patients (i.e. not fit for combination therapies) with unresectable metastatic colorectal cancer (mCRC) is limited to dose-reduced doublet regimens or oral fluoropyrimidines (FP) with bevacizumab. We conducted a systematic review analyzing evidence for oral FPs with epidermal growth factor receptor (EGFR)-directed monoclonal antibodies for patients with RAS wild-type (WT) mCRC across treatment lines.Methods\n\nWe searched PubMed and Cochrane Library for phase II and phase III studies evaluating oral FPs (capecitabine, S-1 or trifluridine/tipiracil (FTD/TPI)) plus EGFR-directed monoclonal antibody (panitumumab or cetuximab) in mCRC. Outcomes included efficacy and safety.Results\n\nSeven publications met inclusion criteria (n = 262 patients). First-line data was limited to elderly cohorts receiving capecitabine plus cetuximab or panitumumab with a median progression-free survival (PFS)/median overall survival (OS) of 7.2/17.1 months (cetuximab) and 7.5/23.7 months (panitumumab), respectively. In third-line and beyond, median PFS for the combination of FTD/TPI plus cetuximab or panitumumab ranged from 2.4 (cetuximab) to 5.8 months (panitumumab), and OS from 9.8 (cetuximab) to 14.2 months (panitumumab). S-1 plus cetuximab was associated with a median PFS of 5.5 months and OS of 13.6 months.Conclusion\n\nWhile capecitabine should not be used together with anti-EGFR antibodies, FTD/TPI in combination with an EGFR-directed antibody appears feasible, shows promising activity and manageable toxicity profile in RAS WT mCRC potentially offering an alternative for frail patients; prospective trials are needed.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Hematology, Oncology and Cancer Immunology (CCM), Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.",
    "German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Centre (DKFZ), Heidelberg, Germany.",
    "Department of Hematology, Oncology and Cancer Immunology (CCM), Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Charitéplatz 1, 10117, Berlin, Germany. arndt.stahler@charite.de.",
    "German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Centre (DKFZ), Heidelberg, Germany. arndt.stahler@charite.de."
  ],
  "article_type": "systematic review",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Alena Annbalou Hasenburg"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Sebastian Stintzing"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Arndt Stahler"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7jbsmpqh3wr1x.bib",
  "cited_by": 0,
  "doi": "10.1007/s00432-026-06639-x",
  "fulltext_url": "https://europepmc.org/articles/PMC13683298",
  "id": "7jbsmpqh3wr1x",
  "issns": [
    "0171-5216",
    "1432-1335"
  ],
  "landing_url": "https://europepmc.org/article/MED/42902018",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC254-282"
    ],
    [
      "openalex",
      "2730|Colorectal Cancer Treatments and Studies"
    ]
  ],
  "openalex": "W7223023952",
  "pdf_url": "https://europepmc.org/articles/PMC13683298?pdf=render",
  "pmcid": "PMC13683298",
  "pmid": "42902018",
  "published": "2026-10-20",
  "publisher": "Springer",
  "ris": "https://research.draconitic.com/paper/7jbsmpqh3wr1x.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:32Z",
      "native_id": "MED:42902018",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42902018"
    },
    {
      "first_seen": "2026-10-30T13:45:34Z",
      "native_id": "56b9d953f10449148bd3bbb115f6dcc8",
      "source": "doaj",
      "url": "https://doi.org/10.1007/s00432-026-06639-x"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Colorectal Cancer Treatments and Studies",
      "subfield": "oncology"
    }
  ],
  "title": "Combination of oral fluoropyrimidines and EGFR-directed antibodies in frail patients with metastatic colorectal cancer: a systematic review.",
  "title_text": "Combination of oral fluoropyrimidines and EGFR-directed antibodies in frail patients with metastatic colorectal cancer: a systematic review.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:45:34Z",
  "url": "https://research.draconitic.com/paper/7jbsmpqh3wr1x",
  "venue": "Journal of cancer research and clinical oncology",
  "versions": []
}