title: [Does the sidedness determine the first line treatment of irresectable metastatic colorectal cancer?]
abstract: OBJECTIVE
  Median life expectancy of non-resectable metastatic colorectal cancer may surpass three years. However, several points of the treatment strategy are subject of ongoing debate. Optimal sequence of targeted agents is not elucidated either. Based on retrospective analyses of six clinical studies and a metaanalysis, the superiority of anti-EGFR agents such as cetuximab and panitumumab over anti-VEGF bevacizumab has been proposed in the treatment of left sided tumours.
  
  
  METHODS
  The results of the six major clinical trials were analysed. Insufficiencies of the meta-analysis are pointed: the lack of homogeneity among control groups, the omission of later lines of therapy, the inconsistency between progression free and overall survival benefit and the high proportion of excluded patients.
  
  
  RESULTS
  The trials confirm the worse prognosis of right sided versus left sided colorectal cancers.
  
  
  CONCLUSIONS
  To date the data are not strong enough to support the preference of any of the available targeted agents at the first line setting in the treatment of left sided metastatic RAS and BRAF wild type colorectal cancers. Several trials suggest that anti-EGFR treatment has no additional benefit as compared to chemotherapy alone in the treatment of right-sided tumours. Orv. Hetil., 2017, 158(9), 340-344.
authors.affiliation: Onkoradiológiai Osztály, Petz Aladár Megyei Oktató Kórház Győr, Vasvári Pál u. 2-4., 9024.
authors.forename: Tamás
authors.initials: T
authors.lastname: Kullmann
authors.affiliation: Onkoradiológiai Osztály, Petz Aladár Megyei Oktató Kórház Győr, Vasvári Pál u. 2-4., 9024.
authors.forename: István
authors.initials: I
authors.lastname: Sipőcz
authors.affiliation: Onkoradiológiai Osztály, Petz Aladár Megyei Oktató Kórház Győr, Vasvári Pál u. 2-4., 9024.
authors.forename: Tamás
authors.initials: T
authors.lastname: Pintér
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D016032:Randomized Controlled Trials as Topic
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents
keywords: bevacizumab; cetuximab; chemotherapy; kemoterápia; metastatic colorectal cancer; panitumumab; áttétes vastagbéldaganat