Dr. Benson on Sequencing Strategies with Cetuximab in CRC

Al B. Benson, MD, professor of medicine, Hematology and Oncology, Northwestern University Feinberg School of Medicine, discusses the optimal sequencing of the EGFR inhibitor cetuximab (Erbitux) for patients with RAS wild-type colorectal cancer (CRC).

There are several ways to sequence EGFR inhibitors in patients with RAS wild-type CRC, explains Benson. Some use cetuximab upfront, often in combination with FOLFIRI.

However, this strategy may not maximize treatment options, Benson says. Instead, upfront FOLFOX in combination with bevacizumab (Avastin), followed by FOLFIRI and bevacizumab at the time of progression may be more efficient.

If further progression occurs, cetuximab or panitumumab (Vectibix) could be used in combination with irinotecan or FOLFIRI. If patients progress on either of these regimens, TAS-102 (trifluridine/tipiracil; FTD/TPI; Lonsurf) or regorafenib (Stivarga) are available options, says Benson.

Beyond this, clinical trials also provide a potential option for patients in any line of therapy.