Gulam A. Manji, MD, PhD, director, Medical Oncology and Translational Research for The Pancreas Center, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, discusses the importance of discovering other actionable targets for patients with colorectal cancer (CRC).

The search continues for additional actionable targets in patients with CRC, says Manji. Identifying these mutations could help increase the efficacy of available treatment and improve patient survival.

 mutations, there has been little success in finding another target present in a large proportion of patients, he explains. For example, in other cancer types, there are rare diseases where a large proportion of patients who have the 

 mutation can benefit from treatment. Unfortunately, that is not the case for gastrointestinal malignancies, says Manji.

However, a considerable percentage of mutation-negative gastrointestinal stromal tumors harbor a 

 translocation, so some efficacy may be seen there, concludes Manji.

Videos

Gulam A. Manji, MD, PhD, discusses the importance of discovering other actionable targets for patients with colorectal cancer.
 

Dr. Manji on Lack of Actionable Targets in Patients with Colorectal Cancer

Gulam A. Manji, MD, PhD, director, Medical Oncology and Translational Research for The Pancreas Center, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, discusses treatment for patients with colorectal cancer (CRC) who harbor 

 fusion-positive CRC can receive therapy with the FDA-approved TRK inhibitor larotrectinib (Vitrakvi).

Patients who are receiving treatment with this class of agents achieve durable responses, according to Manji, which is very positive for a heavily pretreated population.

Gulam A. Manji, MD, PhD, discusses treatment for patients with colorectal cancer who harbor NTRK fusions.

Dr. Manji on Treatment for NTRK Fusion+ CRC

Gulam A. Manji, MD, PhD, director, Medical Oncology and Translational Research for The Pancreas Center, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, discusses the difference between right- and left-sided tumors in colorectal cancer (CRC) and the appropriate treatment for right-sided tumors based on a subgroup analysis.

Patients with right-sided tumors tend to have an increased amount of 

 mutations while patients with left-sided tumors have a higher incidence of HER2-positive disease, explains Manji. Results of a subgroup analysis of patients who were previously treated with chemotherapy and combinations of EGFR-directed therapy show that patients with right-sided tumors do not benefit from EGFR-directed regimens, says Manji.

Therefore, patients with right-sided tumors, regardless of whether they have 

 mutations or not, should not be treated with first-line EGFR-directed therapy. Instead, according to Manji, they should be treated with a combination of chemotherapy and VEGF-directed therapy, such as bevacizumab (Avastin).

Gulam A. Manji, MD, PhD, discusses the difference between right- and left-sided tumors in colorectal cancer and the appropriate treatment for right-sided tumors based on a subgroup analysis. 

Dr. Manji on Treatment for Right-Sided Tumors in CRC

Gulam A. Manji, MD, PhD, director, Medical Oncology and Translational Research for The Pancreas Center, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, discusses clinical trials for patients with colorectal cancer (CRC) harboring 

Although prognosis is poor for patients with 

-mutant CRC, recent combination trials that target 

 mutations are showing intriguing clinical activity, according to Manji.

Manji recommends that all patients with CRC who have 

 mutations and other abnormalities should enroll onto biomarker-driven clinical trials to help researchers get solid data that show proven benefit.

Gulam A. Manji, MD, PhD, discusses clinical trials for patients with colorectal cancer harboring BRAF or other molecular abnormalities.

Dr. Manji on Treatment for BRAF-Mutant CRC

Gulam A. Manji, MD, PhD, director, Medical Oncology and Translational Research for The Pancreas Center, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, discusses the role of finding biomarkers in patients with gastrointestinal (GI) cancers.

Several new clinical trials are showing “small glimpses of hope” with active combination regimens targeting patient populations with newly identified actionable mutations, according to Manji. In particular, Manji believes the future for patients with 

 mutations, translocations, and fusions is “really bright.”

 translocations are found in a small percentage of patients with GI malignancies; therefore, the identification of biomarkers and treatments help a minority of patients, according to Manji. Despite its small impact, Manji is encouraged at the newfound ability to help this patient population.

Gulam A. Manji, MD, PhD, discusses the role of finding biomarkers in patients with gastrointestinal cancers.

Gulam A. Manji, MD, PhD

Articles

Dr. Manji on Lack of Actionable Targets in Patients with Colorectal Cancer

Dr. Manji on Treatment for NTRK Fusion+ CRC

Dr. Manji on Treatment for Right-Sided Tumors in CRC

Dr. Manji on Treatment for BRAF-Mutant CRC

Dr. Manji on Predictive or Prognostic Biomarkers in GI Cancers