Dr. Benson on Considerations for Advanced CRC Treatment

Al B. Benson, MD, professor of medicine, Hematology and Oncology, Northwestern University Feinberg School of Medicine, discusses the factors to consider when approaching treatment for a patient with advanced colorectal cancer (CRC).

Benson says that it is important to emphasize the multiple aspects of advanced CRC treatment, including patient comorbidities and molecular characteristics. For each patient, their RAS, BRAF, and microsatellite instability (MSI) status should be identified before treatment is considered. HER2 is also being explored as a target in ongoing clinical trials of patients with metastatic CRC, suggesting it should also be sequenced for along with the more common markers.

Tumor characteristics and patient preference should also be taken into account when deciding on treatment, Benson says. With multiple opportunities for treatment, it is critical to look at these factors to optimize treatment sequencing, he adds.

Another factor to consider is location. The location of the tumor is based on important molecular characteristics, explains Benson. For example, more MSI-high and BRAF-positive tumors are seen in patients with right-sided CRC.