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Expert Discusses Finding the Optimal Treatment Strategy in CRC

Jason Harris
Published: Saturday, Aug 25, 2018

A. David McCollum, MD

A. David McCollum, MD

Treatment plans for patients with colorectal cancer (CRC), both in first-line and subsequent lines, are growing and changing, said A. David McCollum, MD. Selecting the optimal regimen, managing initial induction therapy and moving into maintenance therapy, means harnessing multiple individual data points and balancing efficacy with toxicity, he explained.

State of the Science Summit™ on Gastrointestinal Cancers, McCollum, an attending oncologist at Baylor University Medical Center, discussed the need for greater use of molecular profiling, the importance of tumor sidedness when selecting a treatment regimen, and the value of maintenance therapy in patients with metastatic disease.

OncLive: Can you provide a summary of your presentation?

McCollum: We spoke about the modern-day management of colon cancer, looking at lines of therapy, progressing through different lines of therapy, and then talking about ways to manage patients who have refractory disease. The majority of the first part of the presentation focused on how to choose an appropriate frontline treatment option, then how one tries to navigate induction therapy and move into maintenance therapy.

We discussed how to segue from that active, intense regimen into this maintenance treatment, and the options available there for patients, which, helps to optimize the balance between quality of life and prolonging life.

What is your position on the use of regorafenib in metastatic disease?

We have 2 approved agents in that space: trifluridine/tipiracil (Lonsurf) and regorafenib. These 2 drugs have never been compared head-to-head, but they have each been compared in pivotal data to supportive care because that is the standard in patients with refractory disease. Both offer an advantage. Using them early enough in the course of illness is important because they can provide benefit for patients.
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