Aparna R. Parikh, MD

Aparna R. Parikh, MD, discusses how trials like PODIUM-303 are reshaping the treatment paradigm for squamous cell anal carcinomas.

This segment explores the rapidly evolving landscape of ctDNA assays and the challenges clinicians face in interpreting and applying these tests in CRC care. The discussion emphasizes that ctDNA technology is advancing at an unprecedented pace, with each new generation of assays differing in methodology, sensitivity, and clinical reporting. As a result, clinicians must remain vigilant about assay versioning, analytic validity, and the implications for treatment decision-making.

In this segment, the discussion centers on the evolving role of ctDNA and MRD testing in CRC, particularly in the curative-intent setting. Experts highlight how ctDNA is increasingly used as both a predictive tool for guiding adjuvant therapy and as a surveillance strategy to monitor for early recurrence. They emphasize that although ctDNA is promising, it remains optional in practice due to limited evidence supporting de-escalation of therapy in certain populations.

This segment focuses on the evolving treatment landscape for refractory mCRC, with an emphasis on how clinicians interpret and integrate new trial data, such as STELLAR-303, into clinical practice. The discussion frames this trial within the context of heavily pretreated patients, highlighting the practical challenges of sequencing therapies like TAS-102, fruquintinib, and regorafenib. The panelists use the trial as a springboard to examine broader themes in treatment decision-making, balancing efficacy, tolerability, and patient-centered considerations.

This segment centers on the practical implementation of biomarker testing in mCRC and the remaining gaps between evidence and real-world practice. The panel begins by affirming that single-gene testing alone is largely obsolete, with most institutions relying on comprehensive NGS using both tissue and liquid biopsy. However, targeted single-gene assays, such as rapid KRAS testing, still play a role in select scenarios, particularly when expedited results are needed for clinical trial eligibility.

In this segment, the panel transitions to a focused discussion of critical biomarkers in mCRC beyond MSI-H/dMMR, emphasizing how rapidly the biomarker landscape has expanded heading into 2026. Faculty underscore that comprehensive molecular testing is no longer optional, as multiple actionable alterations now meaningfully influence treatment selection and outcomes.

This segment focuses on practical decision-making for first-line systemic therapy in patients with unresectable, multi-organ mCRC, particularly those with left-sided, RAS/BRAF wild-type disease. Dr Parikh frames the discussion around ongoing controversies, including the use of triplet versus doublet chemotherapy, timing of anti-EGFR therapy, and balance between efficacy and quality-of-life considerations such as skin toxicity.

This segment transitions the discussion from MSI-H disease to the broader management of mCRC, emphasizing the importance of multidisciplinary care and individualized treatment pathways. Dr Parikh frames the conversation by noting that, unlike many other gastrointestinal malignancies, patients with stage IV CRC can experience long-term survival and, in select cases, achieve cure. As a result, surgical and local therapies remain central considerations even in the metastatic setting.

This segment focuses on best practices for MMR and MSI testing in CRC, emphasizing that biomarker assessment is a critical and “never-miss” step prior to treatment decision-making. Dr Parikh opens by describing institutional reflex testing workflows, in which all newly diagnosed colorectal carcinomas, regardless of stage, automatically undergo immunohistochemistry (IHC) for loss of MMR proteins, rather than universal PCR-based MSI testing.

This segment focuses on real-world toxicity management with immune checkpoint inhibitors, particularly nivolumab plus ipilimumab, and how increasing familiarity has shaped clinician comfort and patient outcomes in MSI-H/dMMR mCRC. The discussion opens with reflections on unexpected or rare immune-related adverse events, highligting the heterogeneous and sometimes unpredictable nature of immunotherapy toxicity. Although classic toxicities such as colitis, pneumonitis, hepatitis, and rash are well recognized, panelists note that unusual presentations can occur and require clinical vigilance.

In this segment, the panel addresses a key clinical question in MSI-H/dMMR mCRC: should dual immune checkpoint blockade with nivolumab plus ipilimumab be used universally upfront, or can clinicians safely sequence therapies and reserve CTLA-4 inhibition for later lines?

Experts discuss the evolving role of ctDNA in managing MSI-high cancer patients, emphasizing non-operative approaches and improved treatment strategies.

Experts discuss recent advancements in precision care for unresectable metastatic colorectal cancer, focusing on innovative treatment strategies and biomarker roles.

Aparna Parikh, MD, discusses the importance of upfront molecular testing in patients with metastatic colorectal cancer.

Aparna Parikh, MD, discusses currently available treatment options for patients with HER2-positive colorectal cancer.

Aparna Parikh, MD, discusses currently available targeted therapy options for patients with colorectal cancer.

Experts discuss key takeaways and closing thoughts on antibody-drug conjugates (ADCs) in cancer treatment.

Key opinion leaders examine promising antibody-drug conjugates (ADCs) in the pharmaceutical development pipeline.

Expert clinicians offer strategic guidance on optimal sequencing of antibody-drug conjugates (ADCs) in treatment protocols.

Aparna Parikh, MD, discusses the rationale for adding ERAS-007 to the BEACON regimen in BRAF V600E–mutated metastatic colorectal cancer.

Experts provide clinical insights on the management of emetogenicity in patients receiving antibody-drug conjugates.

A panel of experts discuss hematologic adverse events associated with antibody-drug conjugate therapies.

Vijayakrishna Gadi, MD, PhD, discusses short-term and long-term treatments with ADCs.

Vijayakrishna Gadi, MD, PhD, discusses the risk of ILD and pneumonitis from ADCs.

Vijayakrishna Gadi, MD, PhD, discusses the role of antibody-drug conjugates in a curative setting.

A panel of experts discuss the challenges of testing for HER2-low access solid tumor types.

A panel of experts discuss if there is a role for HER2-directed ADCs antibody-drug conjugates in GU genitourinary cancers

A panel of experts discuss where HER2-directed ADCs antibody-drug conjugates fit into the overall treatment paradigm.

Dr Garon shares insights on the role of ADCs for the treatment of HER2+ lung cancer.

Dr Gadi leads a discussion on recent data on the treatment of HER2-low tumors, including ASCO updates on the DESTINY-Breast06 trial.