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Nilofer Saba Azad, MD, discusses treatment considerations in right- versus left-sided colorectal cancer.
Nilofer Saba Azad, MD, associate professor oncology, Johns Hopkins University School of Medicine, director, Developmental Therapeutics Clinical Trials Program, Johns Hopkins Sidney Kimmel Cancer Center, discusses treatment considerations in right- versus left-sided colorectal cancer (CRC).
In the CRC space, epidemiological studies have shown that patients with right-sided tumors have more aggressive and potentially resistant disease versus patients with left-sided tumors, Azad says.
Historically, these biological differences were not used to inform treatment selection, explains Azad. Patients with right- and left-sided tumors received the same course of treatments.
However, in the past few years, a series of trials indicated that tumor sidedness does influence response to treatment, Azad says.
Moreover, patients with right-sided tumors appear to respond better to aggressive chemotherapy compared with patients with left-sided tumors, says Azad. Conversely, patients with metastatic disease and left-sided tumors that do not harbor KRAS, BRAF, or NRAS mutations may benefit from EGFR inhibitors in the frontline setting.