Rona D. Yaeger, MD
Three months of adjuvant chemotherapy could be a viable option for most patients with advanced colorectal cancer (CRC), and the addition of targeted therapy should be considered for those with metastatic disease. All patients diagnosed with CRC should be tested for mismatch repair deficiency (dMMR) and microsatellite instability (MSI) to screen for Lynch syndrome and potential treatment with immune checkpoint immunotherapy.
The findings raise the question of whether CAPOX is a better regimen, she said, noting that combination is more frequently administered in Europe, where familiarity may result in higher adherence rates.
Targeted Therapies in Metastatic Disease
Combination therapy is the preferred modality for metastatic CRC (mCRC), according to NCCN guidelines. Yaeger said the FOLFOX or FOLFIRI (5-fluorouracil plus leucovorin and irinotecan) chemotherapy regimens produce equal outcomes with similar response rates in about 50% of patients. “Whatever regimen is chosen, the other can be used in a second-line setting,” she added.
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