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Michael J. Overman, MD, professor in the Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses tailoring approaches to molecular subsets of patients with metastatic colorectal cancer.
Michael J. Overman, MD, associate professor, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, discusses tailoring treatment approaches to molecular subsets in metastatic colorectal cancer (mCRC).
The field of mCRC is unique in that there a number of molecular subtypes that can potentially drive treatment decisions, Overman says. A patient with mCRC should undergo testing for microsatellite instability (MSI), BRAF, RAS, and most recently, HER2. Moreover, there are promising data with single-agent and combination immunotherapy in patients whose tumors are MSI—high and mismatch repair deficient. Immunotherapy is currently being utilized in the second- and third-line settings, Overman notes, but ongoing studies are looking at this treatment in the frontline setting.
For patients with BRAF V600E mutations, the National Comprehensive Cancer Network recommendeds vemurafenib (Zelboraf), cetuximab (Erbitux), and irinotecan as second-line therapy. Overman adds that the anticipated phase III data from the BEACON CRC trial could move the needle even further in this space.