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Molecular Markers Gaining Greater Influence in CRC Paradigm

Caroline Seymour
Published: Wednesday, Mar 27, 2019

Mohamed E. Salem, MD

Mohamed E. Salem, MD

The field of metastatic colorectal cancer (mCRC) is starting to shift away from a one-size-fits-all treatment approach due to the discovery and development of targeted therapies for patients with HER2 amplification, NTRK fusions, and BRAF mutations, said Mohamed E. Salem, MD.

State of the Science Summit™ on Gastrointestinal Malignancies, Salem, a medical oncologist at Levine Cancer Institute, Atrium Health, highlighted ongoing research efforts to potentially improve survival in patients with mCRC.

OncLive: How has the field of mCRC changed in recent years?

Salem: mCRC is a common disease. Until recently, we didn't have many treatment options available. Usually, we would give frontline FOLFOX or FOLFIRI plus a biologic agent to these patients. Once patients progressed on those regimens, we didn't have many options to offer them. In the last few years, we started to have more drugs. For example, regorafenib (Stivarga) was approved by the FDA in 2013. TAS-102 (trifluridine/tipiracil; Lonsurf) was FDA approved in 2014 and became available to patients who progressed on FOLFOX- and FOLFIRI-based regimens.

showing the activity of this agent.

What did the results of the MyPathway trial show?

We're learning from breast cancer. In [that space], we learned about HER2 as a physiology and how to target it. With advances made in technology and the ability of next-generation sequencing, we are able to find HER2 overexpression in about 3% to 5% of patients. This is important, because we have drugs that can be used to target HER2-amplified tumors. A few years ago, the HERACLES trial was presented at the ASCO Annual Meeting and demonstrated the activity of anti-HER2 therapy in the refractory setting.
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