FOLFOXIRI+Bevacizumab (VEGF) extends PFS vs doublets in unresectable liver-only/right-sided/RAS or BRAF-mut mCRC

FOLFOXIRI+bevacizumab (VEGF blockade) was tested as first-line therapy in an individual-patient pooled analysis of 4 randomized trials (TRIBE, TRIBE2, CHARTA, STEAM) focused on initially unresectable liver-only, right-sided and/or RAS or BRAFV600E-mut mCRC (n=300; 170 triplet+bev vs 130 doublet+bev). PFS was 12.3 vs 10.3 months (HR 0.75, P=0.019), OS 29.1 vs 23.3 months (HR 0.85, P=0.253), ORR 64% vs 53% (P=0.076), with similar R0 resection (27% vs 24%); toxicity was higher with the triplet (grade≥3 neutropenia 44% vs 22%, diarrhea 19% vs 4%). These gains mirror prior benchmarks—TRIBE/STEAM show PFS ≈12–12.4 vs 9–9.5 months and OS ≈29.8 vs 25.8 months for triplet+bev vs doublets—with a known trade-off in hematologic/GI AEs.