Dr. Lee on Treatment of Newly Diagnosed mCRC

Michael S. Lee, MD, assistant professor of medicine, Department of Molecular Therapeutics, UNC Lineberger Comprehensive Cancer Center, discusses the treatment of patients with newly diagnosed metastatic colorectal cancer (mCRC).

A lot of the ongoing research in this setting is centered around personalizing care, Lee says. This is really dependent on the biologic agent that is chosen to be paired with frontline chemotherapy. Recent data have shown that chemotherapy backbones of FOLFOX and FOLFIRI are equivalent. A biologic agent, however, should be chosen based on the patient’s underlying mutation status, says Lee.

Patients with KRAS and NRAS mutations are not eligible to receive an EGFR antibody, so they will receive bevacizumab (Avastin) if given a biologic. For patients with RAS mutations, it is still relatively unclear if bevacizumab is more effective than an EGFR antibody like cetuximab (Erbitux) with the chemotherapy backbone. However, ongoing studies are looking at this issue, says Lee.