![]() Published and presented data suggest a possible small benefit for EGFR inhibitors, such as cetuximab or panitumumab, in patients with RAS wild-type tumors located on the left side of the colon. Data consistently indicate that EGFR inhibitors lack benefit in the first-line treatment of patients with a RAS wild-type colon tumor located on the right side. In the presence of wild-type RAS, tumor sidedness becomes an important consideration. In the presence of these mutations, epidermal growth factor receptor (EGFR) inhibitors are excluded as treatment options. TB Mutations in BRAF (V600E) or expanded RAS, which includes KRAS and NRAS, are key genomic factors. H&O What is the significance of BRAF and RAS mutations? However, for most patients, there does not appear to be a significant advantage to FOLFIRINOX vs FOLFOX or FOLFIRI, except for the subgroup with BRAF-mutated tumors and possibly those with liver-limited disease. Wild dose first session plus#1 Younger patients-who have a higher capacity to tolerate more aggressive therapy-are potential candidates for leucovorin, 5-FU, irinotecan, and oxaliplatin (FOLFIRINOX) plus bevacizumab. FOLFIRI seems to have a slight edge over FOLFOX, although the numeric improvement is not statistically significant. They are typically used in combination with biologic agents. Two chemotherapy options are available: leucovorin, 5-fluorouracil (5-FU), and oxaliplatin (FOLFOX) and leucovorin, 5-FU, and irinotecan (FOLFIRI). The selection of first-line therapy for these patients is guided by multiple factors, such as genetic characteristics, microsatellite instability (MSI), the side where the tumor arises, and the patient’s age, comorbidities, and performance status. TB The treatment landscape of metastatic colorectal cancer continues to be refined. H&O What factors guide the selection of first-line treatment for metastatic colorectal cancer? Program Leader, GI Program, Mayo Clinic Cancer Center Professor, Mayo Clinic College of Medicine and Science Highlights in Colorectal Cancer From the 2018 American Society of Clinical Oncology ![]()
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