Dr. Nelson on Novel Combination Therapies in Colorectal Cancer

Douglas A. Nelson, MD, Department of General Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses novel combination therapies in colorectal cancer (CRC).

Recent data from the 2019 Gastrointestinal Cancers Symposium show that patients with genetic abnormalities are deriving more benefit from targeted therapies, explains Nelson. For example, the combination of encorafenib (Braftovi), binimetinib (Mektovi), and cetuximab (Erbitux) demonstrated a significant improvement in median progression-free survival and overall survival in patients with BRAF V600E-mutant metastatic CRC.

In terms of patients with microsatellite instability-high (MSI-H) tumors, immunotherapy has not made as much of an impact as it has in the treatment of other solid tumors. However, data of its use in earlier settings as well as its use in combination with chemotherapy in both the advanced setting and adjuvant setting show promise, says Nelson.

Nelson adds that the idea of targeting HER2 is gaining traction in the field. Although these subsets comprise a small percentage of the overall CRC population, the use of targeted therapy either alone or in combination with chemotherapy can result in significant clinical responses in these patients.