Michel Vulfovich, MD, medical director, Sickle Cell Disease and Gynecology Oncology programs, Memorial Healthcare System, discusses molecular testing in colorectal cancer (CRC).

Standard frontline practice for CRC is to put the majority of patients on chemotherapy with either FOLFOX or CAPOX plus or minus bevacizumab (Avastin), explains Vulfovich. If a patient has a 

 wild-type mutation, they will receive cetuximab (Erbitux) or panitumumab (Vectibix).

Molecular testing is more commonly looked into for second-, third-, and fourth-line treatment, says Vulfovich. Mutations such as 

 have implications for prognosis. For some patients, this information is beneficial in the frontline setting; however, sometimes, even if a patient has a 

 wild-type mutation, the mutation should not be addressed in treatment, concludes Vulfovich.

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Michel Vulfovich, MD, discusses molecular testing in colorectal cancer.

Dr. Vulfovich on Molecular Testing in Colorectal Cancer

Michel Vulfovich, MD, medical director, Sickle Cell Disease and Gynecology Oncology programs, Memorial Healthcare System, discusses the utility of broad molecular profiling in metastatic colorectal cancer (mCRC).

Single-gene testing is no longer sufficient in mCRC, says Vulfovich. Now, broad molecular testing should be done to screen for 

, and microsatellite instability, in addition to 

. Notably, the results can indicate a patient’s prognosis as well as inform treatment.

Typically, patients receive FOLFOX or CAPOX in the frontline setting, says Vulfovich. Depending on whether the tumor is right sided or left sided, bevacizumab (Avastin) can be added, whereas patients with wild-type 

 mutations are more likely to receive cetuximab (Erbitux) or panitumumab (Vectibix) up front. The results of molecular testing could also impact sequencing strategies in the second- and third-line settings, making testing a necessity upon diagnosis, concludes Vulfovich.

Michel Vulfovich, MD

Articles

Dr. Vulfovich on Molecular Testing in Colorectal Cancer

Dr. Vulfovich on Broad Molecular Profiling in mCRC