Observational Study Finds Mixed Survival Outcomes for Targeted Colorectal Cancer Therapies

A large observational study of treatment outcomes in metastatic colon cancer indicates that only some patients experience survival benefits from targeted therapy. The findings, appearing in JAMA Network Open this week, highlight the importance of analyzing outcomes in routine clinical practice instead of only relying on clinical trial results. Current guidelines recommend treating metastatic colon cancer with targeted therapies based on mutation profiles — treatments like epithelial growth factor receptor (EGFR) inhibitors and vascular endothelial growth factor (VEGF) inhibitors. In a new study, investigators from Case Western Reserve University School of Medicine examined data on roughly 9,100 metastatic colorectal cancer patients treated at 800 clinical sites across the US between 2013 and 2020. They find that EGFR inhibitor therapy led to improved survival among patients with certain tumor types, in line with data from randomized clinical trials (RCTs). "Unlike in clinical trials, however, no survival benefit was noted with use of VEGF inhibitors" over non-targeted treatment, the study's authors write. "Given that some of our results differ from those of RCTs, our study highlights the importance of analyzing outcomes using data originating from routine clinical practice."