Amit Mahipal, MBBS
Unless they have a rare genetic alteration, patients with metastatic colorectal cancer (mCRC) should be treated with a chemotherapy backbone and a biologic agent in the frontline setting, said Amit Mahipal, MBBS.
Most patients in the United States will receive FOLFOX with either the VEGF inhibitor bevacizumab (Avastin) or an EGFR-targeted monoclonal antibody, typically cetuximab (Erbitux) or panitumumab (Vectibix), said Mahipal, a professor of medicine at the Mayo Clinic.
Moreover, highly effective targeted therapies are emerging for biomarkers such as BRAF
, and NTRK
. For the rare subset of patients with microsatellite instability high (MSI-H) tumors, immunotherapy both as a single agent and in combination has become a reasonable treatment option and there are ongoing trials attempting to expand the reach of this approach in mCRC.
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