Comparison of first-line cetuximab and panitumumab plus doublet chemotherapies for left-sided colorectal cancer: a multicenter real-world observational study by the Japanese Society for Cancer of the Colon and Rectum

Int J Clin Oncol. 2026 May;31(5):851-858. doi: 10.1007/s10147-026-02999-z. Epub 2026 Mar 4.

Abstract

Background: For patients with left-sided metastatic colorectal cancer (mCRC), the recommended first-line treatment is anti-epidermal growth factor receptor (anti-EGFR) antibodies, such as cetuximab or panitumumab, plus doublet chemotherapy. However, the differences in outcomes between cetuximab and panitumumab remain unknown.

Methods: Clinical data of patients with left-sided all RAS or KRAS wild-type mCRC who received cetuximab or panitumumab plus doublet chemotherapy were retrospectively collected from 24 institutions in Japan. The patients were divided into two groups: the cetuximab and panitumumab groups. Overall survival (OS), progression-free survival (PFS), and response rate (RR) were compared between the two groups.

Results: A total of 233 patients were enrolled: 87 (37.3%) in the cetuximab group and 146 (62.7%) in the panitumumab group. Median OS, PFS, and RR of the cetuximab and panitumumab groups were 26.6 months (95% confidence interval [CI], 19.7-33.4) versus 31.8 months (95% CI, 25.7-37.9), 9.7 months (95% CI, 6.9-12.5) versus 12.4 months (11.1-13.7), and 57.8% versus 71.0%, respectively. In multivariate analysis, OS and RR were significantly better in the panitumumab group than in the cetuximab group (adjusted hazard ratio 0.69, 95% CI 0.50-0.99, p = 0.04; adjusted odds ratio 2.00, 95% CI 1.07-3.73, p = 0.03) and PFS was similar between the two groups (adjusted hazard ratio 0.75, 95% CI 0.55-1.01, p = 0.05).

Conclusion: As a first-line treatment for patients with left-sided all RAS or KRAS wild-type mCRC, panitumumab plus doublet chemotherapy may be suggested better efficacy outcomes than cetuximab plus doublet chemotherapy.

Keywords: Cetuximab; Colorectal cancer; Panitumumab.

Publication types

  • Multicenter Study
  • Observational Study
  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Cetuximab* / administration & dosage
  • Cetuximab* / adverse effects
  • Cetuximab* / therapeutic use
  • Colorectal Neoplasms* / drug therapy
  • Colorectal Neoplasms* / genetics
  • Colorectal Neoplasms* / pathology
  • East Asian People
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Panitumumab* / administration & dosage
  • Panitumumab* / therapeutic use
  • Progression-Free Survival
  • Retrospective Studies

Substances

  • Cetuximab
  • Panitumumab

Supplementary concepts

  • Japanese people