RAS野生型转移性结直肠癌（mCRC）在氟嘧啶（FP）为基础的细胞毒性治疗（CT）联合抗EGFR药物诱导治疗后的维持治疗存在争议。纳入了II-III期随机对照试验。考虑的维持策略包括：观察、抗EGFR或FP单药治疗、FP + 抗EGFR、双药CT + 抗EGFR。FP + 抗EGFR的维持治疗（HR 0.56, 95% CrI 0.36-0.89）相较于观察组表现出最明显的PFS（无进展生存期）益处，在SUCRA分析中排名第一（96.4%）。在考虑OS（总生存期）方面，双药CT + 抗EGFR、FP + 抗EGFR和抗EGFR单药治疗的结果相似。在PFS方面，FP + 抗EGFR维持治疗在BRAF野生型患者和左侧肿瘤中具有价值。在左侧肿瘤中，加入CT的OS益处有限。与双药CT + 抗EGFR相比，FP加抗EGFR显示出有利的安全性。因此，FP + 抗EGFR可以被视为RAS野生型mCRC的有价值的维持治疗选择。可以考虑使用EGFR单药治疗，特别是对于左侧肿瘤。Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.

In RAS wild type (wt) metastatic colorectal cancer (mCRC) maintenance therapy after induction with fluoropyrimidine (FP)-based cytotoxic therapy (CT) plus anti-EGFR agents is controversial.Phase II-III randomized trials were included. Maintenance strategies considered were: observation, anti-EGFR or FP monotherapy, FP + anti-EGFR, doublet CT + anti-EGFR.Maintenance with FP + anti-EGFR (HR 0.56, 95% CrI 0.36-0.89) showed the greatest PFS benefit compared to observation, ranking first on SUCRA analysis (96.4%). Considering OS, doublet CT+ anti-EGFR, FP + anti-EGFR and anti-EGFR monotherapy yielded similar results. For PFS, FP + anti-EGFR confirmed to be valuable in BRAF wt patients and left sided tumors. In left sided tumors, the OS benefit of adding CT was limited. FP plus anti-EGFR showed a favourable safety profile compared to doublet CT + anti-EGFR.FP + anti-EGFR can be considered a valuable maintenance option in RAS wt mCRC. EGFR monotherapy can be considered, especially in left-sided tumors.Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.