Dr Weinberg on Varying Treatment Options in Metastatic Colorectal Cancer

Benjamin Weinberg, MD, assistant professor of medicine, Division of Hematology and Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Medstar Health, discusses varying treatment options for patients with metastatic colorectal cancer (mCRC).

One of the more common types of frontline treatment for patients with mCRC is backbone chemotherapy of 5-fluorouracil (5-FU) or capecitabine (Xeloda). Secondary chemotherapy agents that would be added to the backbone include oxaliplatin or irinotecan. Additionally, physicians can add biologics that target the VEGF pathway, such as bevacizumab (Avastin) or cetuximab (Erbitux), which only work for patients who have KRAS, NRAS, or BRAF wild-type mCRC. Patients with left-sided tumors also typically benefit most from the addition of either bevacizumab or cetuximab.

Lesser-common subsets of patients with mCRC, such as microsatellite instability—high disease, can be treated with PD-1 inhibitors. Additionally, entrectinib (Rozlytrek) and larotrectinib (Vitrakvi) are 2 agents approved for patients NTRK fusion–positive tumors, Weinberg concludes.