Background: Epidermal growth factor receptor (EGFR)–expressing metastatic colorectal cancer (mCRC) with wild-type K-RAS/N-RAS may benefit from anti-EGFR targeted therapy. Objective: This study evaluated the efficacy and quality-of-life outcomes of FOLFIRI chemotherapy with or without cetuximab.Patients and Methods: A prospective study was conducted at Ain Shams University Hospitals between December 2016 and December 2019, including 40 patients with newly diagnosed EGFR-expressing, K-RAS/N-RAS wild-type mCRC. Patients were randomized into two groups: Protocol 1 (cetuximab + FOLFIRI, n = 20) and Protocol 2 (FOLFIRI alone, n = 20). Patients were evaluated clinically, biochemically, and radiologically every 3 months for one year. Quality of life (QoL) was assessed using a structured questionnaire.Results: QoL scores were significantly better in Protocol 1 across general (p < 0.001), physical (p = 0.004), psychological (p = 0.04), familial (p = 0.04), and economic (p = 0.05) domains. Median PFS was significantly longer with Protocol 1 (9 vs. 6 months, p = 0.004).Conclusion: In conclusion, our study reinforces that combining cetuximab with FOLFIRI not only enhances oncologic outcomes but also preserves, and in some domains improves, patient-reported quality of life.
Ibrahim et al. (Sun,) studied this question.