Dr. Cohen on Tailoring Treatment to Individual Subtypes in CRC

Stacey A. Cohen, MD, physician, Seattle Cancer Care Alliance, associate professor, Division of Medical Oncology, University of Washington (UW) School of Medicine, physician, UW Medicine, associate professor, Clinical Research Division, Fred Hutchinson Cancer Research Center, discusses tailoring treatment approaches to individual subtypes in colorectal cancer (CRC).

Certain subtypes of CRC are indicated for targeted therapy, whereas others predict for a lack of response to specific therapeutic options, Cohen says. Moreover, each subgroup is associated with a different prognosis, so it is important to understand the disease state prior to making clinical decisions.

For example, a patient with a peritoneal malignancy has a worse prognosis compared with a patient with standard-risk CRC, Cohen explains. Moreover, the presence of a BRAF mutation confers poor outcomes. As such, a patient that has a BRAF-positive peritoneal malignancy should be treated with a BRAF targeted agent. Additionally, if the patient has good tumor biology and responds to initial therapy, they may not require more aggressive therapy with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy surgery, Cohen concludes.