Marwan G. Fakih, MD, City of Hope

Panelists discuss the most significant unmet needs in treating third-line metastatic colorectal cancer (mCRC), highlight areas where additional research is needed to improve patient outcomes, and explore investigational agents they find promising for future treatment options.

Panelists discuss the frequency of hypertension observed with trifluridine-tipiracil plus bevacizumab and their strategies for monitoring and managing it, as well as their approach to dosing TAS-102 plus bevacizumab in patients with hepatic or renal impairment. They also review common toxicities associated with fruquintinib and regorafenib, including hypertension, hand-foot syndrome, and hepatotoxicity, and share management strategies for these adverse events.

Panelists discuss the common toxicities associated with trifluridine-tipiracil plus bevacizumab in clinical practice, including their typical severity, and share their strategies for managing dose reductions and interruptions due to cytopenias when treating patients with this regimen.

Panelists discuss how health-related quality of life (HRQOL) data influence their treatment decisions for third-line metastatic colorectal cancer (mCRC), how they assess patient symptoms and quality of life in clinical practice, and how the toxicity profiles of different therapies guide their treatment choices.

Panelists discuss their perspectives on the SUNLIGHT trial and how its active-arm comparator design, compared with placebo-controlled trials like FRESCO-2 and CORRECT, influences their treatment approach, while also exploring how specific efficacy outcomes impact their decision-making in third-line metastatic colorectal cancer.

Panelists discuss how patient preferences and lifestyle factors are considered when selecting between treatment options for third-line metastatic colorectal cancer (mCRC) and speak about their approaches to shared decision-making and optimal sequencing of therapies based on clinical context and patient needs.

Panelists discuss their preferred treatment options for patients in the third-line setting of metastatic colorectal cancer (mCRC), focusing on regorafenib, trifluridine-tipiracil plus bevacizumab, and fruquintinib, and share insights on how patient and disease-specific factors influence the selection of the most appropriate regimen for each clinical scenario.

Panelists discuss how “refractory” metastatic colorectal cancer (mCRC) is defined in the third- vs fourth-line setting, and the treatment goals in the third-line setting, focusing on optimizing patient outcomes and managing progression after prior therapies.

John L. Marshall, MD; Marwan G. Fakih, MD; and Joleen M. Hubbard, MD, highlight novel strategies in the metastatic colorectal cancer pipeline that look exciting and consider their integration into future clinical practice.

The rationale for continuing to study the combination of immunotherapies with novel tyrosine kinase inhibitors in metastatic colorectal cancer.

Implications for using the combination of pembrolizumab and lenvatinib to treat patients with metastatic colorectal cancer based on updated data from the LEAP-005 study.

Considerations for treating patients with metastatic colorectal cancer with the combination of nivolumab and regorafenib based on preliminary data.

Drs. John L. Marshall, Marwan G. Fakih, and Joleen M. Hubbard, describe the current role of chemotherapy for frontline metastatic colorectal cancer based on novel treatment advances.

Considerations for frontline immunotherapy for patients with microsatellite instability high metastatic colorectal cancer based on data from the KEYNOTE-177 and CheckMate 142 studies.

Mayo Clinic’s Joleen M. Hubbard, MD, interprets data recently presented on the use of EGFR inhibitors as frontline therapy for appropriate patients with metastatic colorectal cancer.

Tumor characteristics, patient factors, and supporting data that affect frontline treatment decisions for patients with microsatellite stable (MSS) metastatic colorectal cancer.

Metastatic colorectal cancer (CRC) experts discuss tumor sidedness and their current use of next-generation sequencing panels to assess patients and guide treatment decisions.

Reactions to the increase in prevalence of metastatic colorectal cancer (CRC) among a younger patient population despite treatment advances.