Dr. Venook on Important Factors for Treating Patients With CRC

Alan P. Venook, MD, The Madden Family Distinguished Professor of Medical Oncology and Translational Research at the University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, discusses important factors for oncologists to consider when treating patients with colorectal cancer (CRC).

The main issue, according to Venook, is whether the patient can potentially be cured, as some patients with metastatic CRC are curable. Patients with liver metastases have the best chance of being cured, he says.

Oncologists should certainly consider the overall goals of therapy, as well as how aggressively the patient can be treated, says Venook. Research thus far in this space is uncertain, in that there is no clear path for physicians to reference in treating these patients.

Venook compares the FIRE-3 and CALGB/SWOG 80405 studies to illustrate this point. In FIRE-3, the researchers looked at frontline cetuximab (Erbitux) plus chemotherapy versus bevacizumab (Avastin) plus chemotherapy, and showed a benefit with cetuximab. On the other hand, the 80405 study shows no difference between cetuximab and bevacizumab. Thus, Venook says future research should properly square away these inconsistencies and develop a clearer treatment path for these patients.