Dr. Armaghany on Gene Sequencing in CRC

Tannaz Armaghany, MD, an assistant professor at Baylor College of Medicine, discusses up-front gene sequencing in patients with colorectal cancer (CRC).

In the past, metastatic CRC was often considered as 2 diseases, those with KRAS mutations and those with wild-type disease, but with trials such as NCI-MATCH, more targets have emerged, explains Armaghany. While KRAS mutations are the most prominent in this space, presenting in about 50% of all patients, BRAF, HER2, and NTRK fusions have also been identified in patients with CRC.

As such, when genotyping cancer cells, it is better to do a broad panel. Gene sequencing should be done up front, according to Armaghany, because the presence of these targets will impact the treatment patients receive. For example, patients with HER2 or RAS wild-type amplifications typically do not respond to EGFR inhibitors. For this reason, up-front gene sequencing is the best course of action for patients diagnosed with CRC, concludes Armaghany.