Comparison of efficacy and safety for patients with beyond second line treated metastatic colorectal cancer: a network meta-analysis of randomized controlled trials.

Patients with metastatic colorectal cancer (mCRC) beyond second line treatment have a poor prognosis. Regorafenib, TAS-102, fruquintinib, panitumumab and cetuximab are recommended single-agent chemotherapy regimens for patients exhibiting disease progression, this meta-analysis aimed to evaluate the efficacy and safety of these regimens in randomized controlled trials (RCTs). Eight RCTs with 3,832 cancer patients were included. Results showed that there was no significant difference in OS and PFS among the four drugs when comparing all patients or patients who have the KRAS gene mutation. In patients with wild-type KRAS, the four drugs exhibited significantly better OS and PFS than the placebo group, with the exception of OS with panitumumab treatment. Fruquintinib exhibited better PFS, good tolerability and reduced gastrointestinal adverse effects in wild-type KRAS subgroup, making it a promising agent to treat patients with wild-type KRAS mCRC beyond the second line.