Dr. Eng on the Treatment Landscape in Metastatic Colorectal Cancer

Cathy Eng, MD
Published: Tuesday, Feb 12, 2019



Cathy Eng, MD, professor of gastrointestinal medical oncology, The University of Texas MD Anderson Cancer Center, discusses the treatment landscape in newly diagnosed metastatic colorectal cancer (mCRC).

There are many therapeutic options for patients with mCRC, although the majority have retained their chemotherapeutic backbone, says Eng. It is important to keep that in mind, as many patients express interest in pursuing immunotherapy. In reality, patients who are eligible for this approach account for less than 5% of the total mCRC population, she adds.

In terms of standard regimens, physicians can use FOLFOX or FOLFIRI. However, if a patient has a good performance status and their laboratory tests are within normal limits, Eng advises a more aggressive approach with FOLFOXIRI.

In terms of clinical factors, sidedness plays an extremely important role in the treatment of patients with treatment-naïve mCRC, as it can help physicians determine whether the patient would benefit from anti-EGFR therapy. Molecular testing is also available to oncologists and should be used earlier rather than later. Molecular testing can help clinicians formulate a treatment strategy so that if a patient becomes intolerant or has an allergic sensitivity reaction to a particular therapy, they are prepared with a subsequent line of therapy.
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Cathy Eng, MD, professor of gastrointestinal medical oncology, The University of Texas MD Anderson Cancer Center, discusses the treatment landscape in newly diagnosed metastatic colorectal cancer (mCRC).

There are many therapeutic options for patients with mCRC, although the majority have retained their chemotherapeutic backbone, says Eng. It is important to keep that in mind, as many patients express interest in pursuing immunotherapy. In reality, patients who are eligible for this approach account for less than 5% of the total mCRC population, she adds.

In terms of standard regimens, physicians can use FOLFOX or FOLFIRI. However, if a patient has a good performance status and their laboratory tests are within normal limits, Eng advises a more aggressive approach with FOLFOXIRI.

In terms of clinical factors, sidedness plays an extremely important role in the treatment of patients with treatment-naïve mCRC, as it can help physicians determine whether the patient would benefit from anti-EGFR therapy. Molecular testing is also available to oncologists and should be used earlier rather than later. Molecular testing can help clinicians formulate a treatment strategy so that if a patient becomes intolerant or has an allergic sensitivity reaction to a particular therapy, they are prepared with a subsequent line of therapy.



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