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Expert Says Clinical Trials Are Essential for Progress in Metastatic CRC

Angelica Welch
Published: Wednesday, Dec 13, 2017

Shubham Pant, MD

Shubham Pant, MD
Third-line treatment options for patients with metastatic colorectal cancer (CRC) essentially boil down to regorafenib (Stivarga) and TAS-102 (Lonsurf), according to Shubham Pant, MD.

In an interview during the event, Pant stressed the importance of clinical trials as an avenue to establish more novel treatment decisions in this setting.

OncLive: Please provide an overview of your lecture on metastatic CRC.

Pant: We have [treatment options] in the first 2 lines but, in the third line, we do not have so many options. However, more options are being developed. We have 2 options essentially, regorafenib and TAS-102, but my whole talk focused on where we are going to go from here—the emerging therapies, targeted therapies, and immunotherapies for CRC in the third-line setting.

How do you approach third-line treatment for a patient with metastatic CRC?

Normally, before that, we try to get some profiling on the patient such as next-generation sequencing. We try to identify targets but, obviously, this depends on how the performance status is—it has to be really good. Then, we try to identify a clinical trial for them that we can use for targeted therapy. 

What regimens currently being explored in clinical trials look promising?

The “pie” of third-line CRC is a big pie, but if you break it down into specialties, such as BRAF-mutant disease, HER2/neu-positive, and MSI-high CRC, we can find new therapies in all categories. Immunotherapy works in some, targeted therapies work in others, and some [tumors require] a combination.
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