Dr. Hubbard on Sequencing Challenges With EGFR Inhibitors in CRC

Joleen M. Hubbard, MD, associate professor of oncology, consultant, practice chair, and vice chair, Division of Medical Oncology, Department of Oncology, Mayo Clinic, discusses sequencing challenges regarding EGFR inhibitors in colorectal cancer (CRC).

For patients with left-sided, RAS wild-type, BRAF wild-type CRC, the question of when to sequence EGFR inhibitors remains largely unanswered, Hubbard says. As such, discussing EGFR inhibitors as an option with patients is important.

Utilizing EGFR inhibitors as maintenance therapy presents additional challenges because these agents are associated with cosmetic adverse effects, Hubbard says. Additionally, EGFR inhibitors could be reserved for later-line therapy since they have demonstrated activity in this space.

The ongoing phase 2 PULSE trial (NCT03992456) is evaluating whether retreatment with the EGFR inhibitor panitumumab (Vectibix) is superior to standard treatment with regorafenib (Stivarga) or TAS-102 (trifluridine/tipiracil; Lonsurf) in patients with metastatic and/or unresectable RAS wild-type CRC. The results of this study could provide additional insight into whether retreatment with an EGFR inhibitor is a viable strategy for patients with CRC, concludes Hubbard.