Dr. Kasi Discusses Treatment Approaches for mCRC

Pashtoon M. Kasi, MD, MBBS, MS, an assistant professor of Oncology and senior associate consultant in the Division of Hematology/Oncology, Mayo Clinic, discusses treatment approaches for patients with metastatic colorectal cancer (mCRC).

CRC is a very heterogeneous disease, and Kasi refers to it as the “poster child” for individualized medicine. Even though researchers mostly consider CRC as 1 entity, even the left side of the colon behaves differently than the right side. When deciding on what the right treatment approach is for a patient, mutational profile factors into play, and age as well as other characteristics that make the patient's tumor unique need to be considered.

Specifically, in mCRC, researchers have to differentiate between patients with widespread metastatic disease and those with oligometastatic disease, Kasi notes. For example, if a patient only has a few metastases in the liver, Kasi shares that he would start off with chemotherapy, and if they [still] have these few spots, he would then use a multidisciplinary approach to remove the metastases and provide the patient with the best chance of cure.

Beyond that, in mCRC, individualizing care based on the tumor is important, especially with patients who have RAS mutations because these mutations can render some treatments ineffective.