原发肿瘤 (PT) 侧面是转移性结直肠癌 (mCRC) 的既定预后标志物，对 RAS 患者抗表皮生长因子受体 (抗 EGFR) 抗体 [单克隆抗体 (mAb)] 的疗效具有预测影响野生型 mCRC。这项研究的重点是 BRAFV600E 突变 (BRAFmt) mCRC 患者，并检查抗 EGFR mAb 与原发性肿瘤单侧性 (PTS) 相关的疗效。这项汇总分析是使用来自五项随机研究的个体患者数据进行的。 mCRC 的线路设置。感兴趣的人群仅限于患有 BRAFmt mCRC 和已知 PTS 的患者。为了进行分析，将治疗分为两组：使用抗 EGFR mAb 治疗的组和未使用抗 EGFR mAb 治疗的组。使用卡方或 Fisher 精确检验比较二分变量，例如总体缓解率和客观缓解率 (ORR)。使用 Kaplan-Meier 方法、对数秩检验和 Cox 回归分析事件发生时间终点 [无进展生存期 (PFS) 和总生存期 (OS)]。通过 Cox 回归进行交互测试。总共确定了 102 名 BRAFmt mCRC 患者。靶向治疗的类型（基于抗 EGFR 的治疗与非抗 EGFR 治疗）对结果没有显着影响。然而，在左侧原发性肿瘤患者中，与非抗 EGFR 治疗相比，基于抗 EGFR mAb 的治疗与更高的 ORR 相关（58% 对比 34%；P < 0.01），并有改善 PFS 的趋势。危险比（HR）0.62； 95%置信区间（CI）0.34-1.13； P = 0.12]，并表现出延长的 OS（HR 0.38；95% CI 0.20-0.72；P < 0.01）。在右侧原发性肿瘤患者中，基于抗 EGFR 的治疗对 ORR 没有影响（33% 对比 36%；P > 0.99），导致 PFS 较差（HR 1.97；95% CI 1.12-3.47；P = 0.02） ，并且 OS 呈较差趋势（HR 1.76；95% CI 0.99-3.13；P = 0.05）。该分析表明，PTS 对 BRAFmt mCRC 一线治疗中抗 EGFR mAb 的疗效具有预测价值。 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Primary tumor (PT) sidedness is an established prognostic marker in metastatic colorectal cancer (mCRC) and has a predictive impact on the efficacy of anti-epidermal growth factor receptor (anti-EGFR) antibody [monoclonal antibody (mAb)] in patients with RAS wild-type mCRC. This investigation focuses on patients with BRAFV600E-mutated (BRAFmt) mCRC and examines the efficacy of anti-EGFR mAbs in relation to primary tumor sidedness (PTS).This pooled analysis was carried out using individual patient data from five randomized studies in the first-line setting of mCRC. The population of interest was limited to patients with BRAFmt mCRC and known PTS. For analysis, treatment was stratified into two groups: those treated with anti-EGFR mAbs and those without. Dichotomous variables, such as overall response rate and objective response rate (ORR), were compared using chi-square or Fisher's exact test. Time-to-event endpoints [progression-free survival (PFS) and overall survival (OS)] were analyzed using the Kaplan-Meier method, log-rank test, and Cox regression. An interaction test was carried out via Cox regression.A total of 102 patients with BRAFmt mCRC were identified. The type of targeted therapy (anti-EGFR-based versus non-anti-EGFR) did not significantly impact the outcome. However, in patients with left-sided primary tumors, anti-EGFR mAb-based treatment, compared with non-anti-EGFR, was associated with a higher ORR (58% versus 34%; P < 0.01), trended toward improved PFS [hazard ratio (HR) 0.62; 95% confidence interval (CI) 0.34-1.13; P = 0.12], and demonstrated prolonged OS (HR 0.38; 95% CI 0.20-0.72; P < 0.01). In patients with right-sided primary tumors, anti-EGFR-based therapy had no effect on ORR (33% versus 36%; P > 0.99), induced inferior PFS (HR 1.97; 95% CI 1.12-3.47; P = 0.02), and trended toward a worse OS (HR 1.76; 95% CI 0.99-3.13; P = 0.05).This analysis suggests that PTS has predictive value for the efficacy of anti-EGFR mAb in the first-line treatment of BRAFmt mCRC.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.