Dr. Bekaii-Saab on Moving Metastatic Treatment Strategies to the Adjuvant Setting in CRC

Tanios S. Bekaii-Saab, MD, FACP, medical oncologist, medical director, Cancer Clinical Research Office, vice chair and section chief, Medical Oncology, Department of Internal Medicine, Mayo Clinic, discusses moving metastatic treatment strategies to the adjuvant setting in colorectal cancer (CRC).

Certain biologic agents that have transformed the treatment of later-stage CRC could improve responses and potentially cure patients in the adjuvant setting, explains Bekaii-Saab.

For example, the randomized phase 3 ATOMIC study is investigating the combination of chemotherapy with or without atezolizumab (Tecentriq) for patients with stage 3 mismatch repair deficient CRC.

Utilizing BRAF or HER2-directed therapies in earlier settings is also an area of investigation, says Bekaii-Saab.

Additionally, predictive biomarkers such as circulating free DNA (cfDNA) may inform whether a patient should receive chemotherapy, explains Bekaii-Saab. For example, a patient without residual disease as determined by cfDNA assessment may not need chemotherapy.

cfDNA may also indicate how intensive the chemotherapy regimen should be for a particular patient, concludes Bekaii-Saab.