Dr Marshall on Key Takeaways from the 2023 SOGO Annual Meeting in GI Cancer

John L. Marshall, MD, chief, Hematology and Oncology, professor, medicine and oncology, director, Otto J. Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University, discusses the key takeaways from the 8th Annual School of Gastrointestinal Oncology^® (SOGO) and remaining unmet needs for patients with metastatic colorectal cancer (CRC).

Marshall, who served as the co-chair of SOGO, reviewed emerging targetable lesions in patients with mCRC. Microsatellite instability, RAS mutations, and BRAF mutations are established markers in the treatment of CRC; however, HER2 has emerged as one of the newest targets of interest in the space, Marshall says. HER2 positivity occurs in approximately 3% to 5% of patients with CRC, Marshall expands. A new treatment emerged for this subgroup of patients in January 2023, when the FDA granted accelerated approval to tucatinib (Tukysa) in combination with trastuzumab (Herceptin) for adult patients with RAS wild-type, HER2-positive unresectable or metastatic CRC that has progressed after treatment with fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy.

RAS mutations are common in patients with CRC, and there are several different RAS mutations that can occur in this patient population. Targeted therapies have emerged for patients with KRAS G12C mutations; however, these are not very common in CRC, Marshall notes, adding that there are many other RAS mutations are more prevalent.

Targeted therapies for other subtypes of RAS mutations are being explored in various clinical trials, and developing new treatments for these subsets of patients would address a major unmet need in CRC, Marshall concludes.