Dr. Azad on Treatment Considerations in Right- Versus Left-Sided CRC

Nilofer S​aba Azad, MD, associate professor oncology, Johns Hopkins ​University School of Medicine, ​director, Developmental Therapeutics Clinical Trials Program, Johns Hopkins Sidney Kimmel Cancer Center, discusses treatment considerations in right- versus left-sided colorectal cancer (CRC).

In the CRC space, epidemiological studies have shown that patients with right-sided tumors have more aggressive and potentially resistant disease versus patients with left-sided tumors, Azad says.

Historically, these biological differences were not used to inform treatment selection, explains Azad. Patients with right- and left-sided tumors received the same course of treatments.

However, in the past few years, a series of trials indicated that tumor sidedness does influence response to treatment, Azad says.

Moreover, patients with right-sided tumors appear to respond better to aggressive chemotherapy compared with patients with left-sided tumors, says Azad. Conversely, patients with metastatic disease and left-sided tumors that do not harbor KRAS, BRAF, or NRAS mutations may benefit from EGFR inhibitors in the frontline setting.