Al B. Benson, MD, professor of medicine, Hematology and Oncology, Northwestern University Feinberg School of Medicine, discusses treatment for patients with resectable colorectal cancer (CRC).
Al B. Benson, MD, professor of medicine, Hematology and Oncology, Northwestern University Feinberg School of Medicine, discusses treatment for patients with resectable colorectal cancer.
If a patient presents with potentially resectable disease, a multidisciplinary team should be brought in so that the surgeon and the radiologist can help determine whether the tumor is resectable.
If the disease is deemed resectable, Benson recommends giving a limited course of neoadjuvant therapy, which typically ranges between 2 and 4 months. It’s not as important to shrink the tumor because the disease is already resectable, adds Benson. By administering chemotherapy, the patient’s chemosensitivity can be assessed, which could then guide treatment decisions down the line, says Benson.
The use of chemotherapy in the newly-diagnosed setting is included in the National Comprehensive Cancer Network guidelines, and reinforced by data from the phase III CALGB/SWOG 80405 trial (NCT00265850). Common regimens include FOLFOX, CAPOX, or FOLFIRI plus a biologic. If the patient has a RAS mutation, bevacizumab (Avastin) would be considered, whereas if the patient has RAS wild-type disease, either cetuximab (Erbitux) or panitumumab (Vectibix) could serve as potential options, concludes Benson.