Dr. Raghav on First-Line Treatment Options in CRC

Kanwal Raghav, MBBS, MD, associate professor, Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses first-line treatment options for patients with colorectal cancer (CRC).

The arsenal for treating patients with CRC includes cytotoxic chemotherapy, targeted agents, immunotherapy, and some treatments specifically for use in the salvage-line settings, according to Raghav. Additionally, molecular profiling should be done up front for patients with metastatic disease, as it significantly changes their standard-of-care management, and can help prepare them for future treatment strategies, including clinical trials, Raghav says.

Generally, immunotherapy, such as pembrolizumab (Keytruda), is recommended up front for patients with mismatch repair deficient or microsatellite instability–high CRC, Raghav notes. In the larger subset of patients with mismatch repair proficient disease, those who harbor a RAS mutations have limited treatment options. As such, these patients are often treated with cytotoxic chemotherapy and anti-VEGF agents such as bevacizumab (Avastin) in the first-line setting, Raghav concludes.