Dr. Grothey on Biomarkers to Inform Metastatic CRC Treatment Decisions

Axel Grothey, MD, a medical oncologist and director of Gastrointestinal Cancer Research at West Cancer Center and Research Institute, discusses biomarkers that can help to guide the treatment of metastatic colorectal cancer (CRC).

The main factors that influence treatment choices in metastatic CRC include molecular markers, such as KRAS, NRAS, HRAS, HER2, and BRAF mutations, as well as microsatellite instability status, says Grothey. However, other factors beyond are also becoming more commonly used within the field.

Now, with individualized therapy, which was previously based on molecular markers, factors such as age, performance status, and therapy goal are being considered. Most recently, tumor sidedness has also become a factor that influences the choice of therapy in terms of how aggressive it should be, says Grothey. 

For example, it is known that right-sided tumors are more aggressive and patients who have them have a poorer prognosis. CRC tumor sidedness also raises the question as to whether or not EGFR receptor antibodies should be used for first- and second-line therapy, concludes Grothey.