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Navigating the Complexities of Tumor Sidedness in Colorectal Cancer

Brandon Scalea
Published: Monday, May 06, 2019

Scott Kopetz, MD, PhD, FACP

Scott Kopetz, MD, PhD, FACP

Tumor sidedness plays an integral role in the prognosis of patients with colorectal cancer (CRC), and recent research on primary tumor location has allowed practitioners to tailor treatment to improve outcomes, said Scott Kopetz, MD, PhD, FACP.

“We now have a much better knowledge of the biologic underpinning of, ‘why does right versus left matter?’” said Kopetz, an associate professor of Gastrointestinal Medical Oncology at The University of Texas MD Anderson Cancer Center. “Together, with the strong clinical data and our understanding of the biology, we are at a point where our practice should be changing.”

To date, several studies have indicated a differential response to targeted therapy in terms of tumor sidedness. Patients with right-sided CRC often have poor responses to EGFR-targeted therapies, said Kopetz, and therefore should not receive agents such as cetuximab (Erbitux) or panitumumab (Vectibix), regardless of their molecular status. In contrast, EGFR inhibition appears to improve overall survival (OS) for patients with left-sided disease.

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