The main loser in the surprisingly broad second-line label for Avastin: IMCL.
The major rationale for using Erbitux in second-line CRC, despite its being off-label, has been that there was no clinical data to justify using Avastin in both the first and second lines. Now, with the broad second-line label for Avastin that is not restricted to Avastin-naïve patients, the FDA has effectively endorsed the use of Avastin in multiple lines of therapy. Why would anyone now use Erbitux off-label in the second line when they can use Avastin on-label?