Dr. Raghav on Ongoing Research With Immunotherapy and Targeted Therapy in CRC

Kanwal Raghav, MBBS, MD, associate professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses ongoing research with immunotherapy and targeted therapy in colorectal cancer (CRC).

Several trials are evaluating the use of checkpoint inhibitors in the frontline setting in patients whose tumors are mismatch repair deficient, says Raghav. One of the larger trials that Raghav recommends, which is currently enrolling patients, is comparing chemotherapy alone with chemotherapy plus immunotherapy in patients with newly diagnosed mCRC.

The current standard of care for patients with BRAF V600E—mutant mCRC is an EGFR-/BRAF-targeted doublet based on data from the BEACON CRC study, which showed improved overall survival with the doublet versus physician’s choice of chemotherapy. Investigators at The University of Texas MD Anderson Cancer Center are attempting to build on that by evaluating an anti-BRAF/EGFR combination plus nivolumab (Opdivo). Other trials are trying to inhibit another player in the ERK pathway to further increase the efficacy of these drugs, says Raghav.

For HER2, many studies are evaluating immunotherapy and antibody-drug conjugates. One of the largest studies, the randomized SWOG S1613 trial, is currently running. In the trial, patients will be randomized to trastuzumab (Herceptin)/pertuzumab (Perjeta) or cetuximab (Erbitux) and irinotecan, which is the current standard of care in this population, says Raghav.