FOLFIRI–cetuximab (EGFR mAb) sequencing fails to beat bevacizumab strategy on disease control in RAS/BRAFV600E WT mCRC

STRATEGIC-1 (GERCOR-PRODIGE-39; Phase III, randomized, open-label; NCT01910610) enrolled untreated, unresectable RAS/BRAFV600E wild-type metastatic colorectal cancer (n=263) to compare Arm A (FOLFIRI+cetuximab → mFOLFOX6+bevacizumab) vs Arm B (OPTIMOX+bevacizumab → FOLFIRI+bevacizumab → EGFR mAb±irinotecan). The primary endpoint duration of disease control was essentially identical: median 22.8 vs 23.5 months (HR 1.01; p=0.945), with median OS 40.4 vs 34.4 months (HR 1.30; 95% CI 0.99–1.72). First-line ORR favored the upfront EGFR approach (82.4% vs 65.4%), but later-line ORR was similar (20.7% vs 16.4); safety was described as consistent with known profiles—overall, the trial was negative/inconclusive for “best” sequencing, and outcomes land in the ballpark of other first-line biologic+doublet approaches (eg, ~29–30 month median OS across cetuximab- vs bevacizumab-based first-line strategies in KRAS WT populations).