Richard Kim, MD, discusses how molecular profiling can be used to optimize outcomes in patients with metastatic colorectal cancer.
Richard Kim, MD, assistant professor of oncology, University of South Florida College of Medicine, and medical oncologist, Department of Gastrointestinal Oncology, Moffitt Cancer Center, discusses how molecular profiling can be used to optimize outcomes in patients with metastatic colorectal cancer (mCRC).
Several targetable biomarkers exist in mCRC, including BRAF, KRAS, microsatellite instability, TRK, and HER2. Patients with stage IV disease should undergo molecular profiling at the time of diagnosis to determine the optimal treatment course, says Kim.
For example, patients with BRAF-mutant mCRC tend to have a poor prognosis; these patients may not have the luxury of receiving third- or fourth-line therapy. The phase III TRIBE study was designed to evaluate more intensive chemotherapy in combination with bevacizumab (Avastin) in patients with RAS- or BRAF-mutant mCRC. Notably, the median overall survival of patients with BRAF-mutant disease who received FOLFOXIRI and bevacizumab was 19.1 months, which compares favorably with historical rates of 9 to 14 months, concludes Kim.