Dr. Eng on Surgical Considerations for RAS-Mutant CRC

Cathy Eng, MD, FACP, FASCO, the David H. Johnson Chair in Surgical and Medical Oncology; co-leader of the Gastrointestinal (GI) Cancer Research Program; professor of medicine in hematology and oncology; co-director of GI Oncology; vice chair of the SWOG GI Committee; and director of the VICC Young Adult Cancers Initiative at Vanderbilt-Ingram Cancer Center, discusses surgical considerations for patients with RAS-mutant colorectal cancer (CRC).

When forming treatment strategies for patients with RAS-mutated disease, it is important to consider whether they are the right candidate for surgical liver resection, Eng says. While the research supporting this strategy was conducted at a single institution, as a result, a uniform follow-up and a uniform approach to neoadjuvant therapy was utilized in this patient population prior to surgical resection, Eng explains. Moreover, a standard approach for surveillance was used, with patients being followed very stringently. Additionally, the study analyzed 573 patients.

However, Eng explains that the research would not necessarily prevent her from recommending surgical resection for a young, RAS-positive patient. The best options should be provided to all patients, especially young patients who are in excellent health, with a good performance status, she explains. Moreover, it is important to be cautious, as RAS-mutant patients are at a higher risk for not benefitting from surgical resection, though resection is the best way to cure a patient, Eng concludes.