Opinion
Video
Targetable Mutations Investigated Or Utilized in mCRC
Medical experts explore the main treatment goals and modalities beyond pharmacotherapies for mCRC treatment, and discuss targetable mutations being explored in mCRC.
John L. Marshall, MD, and David Fenstermacher, PhD, discuss the treatment goals and targetable mutations in metastatic colorectal cancer (mCRC).
Dr Marshall explains that many patients initially hope for a cure when they receive a diagnosis of mCRC. Although some advancements have been made, most treatments are not curative. He stresses the importance of considering local treatment options for patients with limited metastases and discusses the concept of oligometastatic disease. The multidisciplinary team collaborates to determine whether complete eradication of metastases is possible or whether the goal should be to focus on maintaining quality of life.
Dr Marshall emphasizes the role of molecular testing in guiding treatment decisions. Identifying targetable mutations, understanding tumor burden, and setting goals are crucial aspects of shared decision-making. He highlights the dynamic nature of colorectal cancer treatment, emphasizing the importance of precision medicine and tailoring therapy based on molecular profiling.
Dr Fenstermacher continues the discussion by elaborating on targetable mutations in mCRC. He mentions targetable mutations such as BRAF and the new drug Cross, which targets KRAS G12C and other mutations. Dr Fenstermacher explains how the combination of Cross with EGFR inhibitors can achieve a 45% response rate in some cases.
He also discusses the importance of HER2 amplification and the use of drugs such as Herceptin for eligible patients. Dr Fenstermacher stresses the significance of microsatellite instability (MSI) and the potential of immunotherapies in patients with MSI-high tumors. The concept of creating neoantigens and neoepitopes to activate the immune system is explored, providing hope for more effective treatments.
Dr Fenstermacher highlights the evolving landscape of targetable mutations in colorectal cancer, offering optimism for future treatments. He encourages understanding the genetic stability of tumors and exploring new biomarkers that provide opportunities for innovative therapies.
The conversation underscores the ever-evolving and exciting potential of precision medicine and immunotherapy in improving the outcomes and treatment options for patients with mCRC.
Video synopsis is AI-generated and reviewed by AJMC editorial staff.
