Dr. Atreya on How the NCCN Guidelines Have Impacted Treatment Options in mCRC

Chloe E. Atreya, MD, PhD, assistant clinical professor, Department of Medicine, University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, discusses the molecular subgroups in metastatic colorectal cancer (mCRC) and viable treatment options for patients with microsatellite instability (MSI)-high and BRAF-mutated cancers.

Subgroups include patients who have MSI-high and BRAF-mutated tumors. The CheckMate-142 study combined nivolumab (Opdivo) with or without ipilimumab (Yervoy). The combination in that study yielded a 55% overall response rate and 80% disease control rate.

For BRAF-mutated tumors, the 2018 National Comprehensive Cancer Network (NCCN) guidelines now include the S1406 strategy. The study looked at the use of irinotecan plus cetuximab (Erbitux) and vemurafenib (Zelboraf) as a potential option for these patients in the second-line setting. Although it is not FDA approved, its inclusion in the NCCN guidelines will make it more available for patients with BRAF-mutated colon cancers to receive vemurafenib.