Mikhail Fedyanin, MD, PhD, Russian Academy of Medical Science, discusses future approaches for the treatment of patients with colorectal cancer (CRC).

There will hopefully be more novel agents approved in the CRC space, Fedyanin explains, such as combination regimens of MEK inhibitors and PD-1 inhibitors. Additionally, he predicts and anticipates more research dedicated to treatments for patients with CRC who harbor 

 mutations. Currently, there are a lack of effective agents able to target this patient population. 

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Dr. Fedyanin on Future Treatment Landscape of CRC

Mikhail Fedyanin, MD, PhD, Russian Academy of Medical Science, discusses mutation discordance in the primary tumor and metastases in patients with colorectal cancer (CRC), as well as the benefits of liquid biopsy.

A study found that patients with mutant RAS in the primary tumor had a higher chance of a changed RAS status in metastases than patients with wild-type RAS in primary tumors. This situation is unusual, says Fedyanin, and if the discordance is confirmed, JAK inhibitor antibodies could be considered.

The study utilized liquid biopsy, which extracts circulating tumor cells, cell-free DNA, or exosomes from blood and urine. This was key to determining the study’s findings, says Fedyanin. It allowed researchers to understand how the mutational status changed throughout the study without additional invasive procedures.

Mutations can occur during treatment, when biopsies can not be performed on each metastasis Liquid biopsy allows oncologists to find the whole spectrum of mutations every time, says Fedyanin.

Dr. Mikhail Fedyanin on Mutation Discordance and Liquid Biopsy in CRC

Mikhail Fedyanin, MD, PhD, Russian Academy of Medical Science, discusses mutation discordance in the primary tumor and metastases in patients with colorectal cancer (CRC).

The concordance of mutational status between primary tumor and metastases in CRC is typically between 80 to 95%, says Fedyanin. But in his study they identified a high discordance status. This is connected to the time between primary tumor resection and metastasectomy, which is about 1 year.

Other studies investigating this same area also found mutation discordance in KRAS, NRAS, BRAF and other genes.

Mikhail Fedyanin, MD, PhD

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Dr. Fedyanin on Future Treatment Landscape of CRC

Dr. Mikhail Fedyanin on Mutation Discordance and Liquid Biopsy in CRC

Dr. Mikhail Fedyanin on Mutation Discordance in CRC