Dr Ng on Factors That Influence Later-Line Treatment Decisions in mCRC

Kimmie Ng, MD, MPH, associate chief, Division of Gastrointestinal Oncology, director, Young-Onset Colorectal Cancer Center, co-director, Colon and Rectal Cancer Center, physician, Dana-Farber Cancer Institute; associate professor, medicine, Harvard Medical School, discusses factors of consideration when approaching later-line treatment decisions for patients with refractory metastatic colorectal cancer (mCRC).

It is a challenging scenario when both first-line and second-line standard therapies fail to benefit patients with mCRC, Ng begins. In such cases, deciding the next course of action involves evaluating the availability of clinical trials that might be suitable for the patient, she explains. Equally important is considering the patient’s quality of life and performance status, which helps determine what types of treatments they can tolerate, Ng says. She notes that each patient’s individual profile and unique circumstances are carefully taken into account when selecting the most appropriate treatment strategy.

Unfortunately, when colorectal tumors become refractory to standard therapies, treatment options become more limited, she continues. It is particularly disheartening that, in the current era, immunotherapy has not been effective for the majority of patients with microsatellite-stable (MSS) CRC, the most common subtype of this disease, Ng adds. As a result, there is ongoing research focused on optimizing immunotherapy strategies for patients with MSS CRC, she emphasizes, relaying that researchers, such as herself, are also heavily invested in developing new, innovative targeted therapies to better address this disease.

Although new drugs targeting BRAF and HER2 are now commercially available and represent significant advances in the management of mCRC, the responses to these therapies are often brief, Ng expands. Therefore, there is a critical need to gain a deeper understanding of the mechanisms driving resistance to these treatments, she states. Additionally, further research is essential to determine the most effective combination therapies that can overcome resistance and provide more durable responses, Ng concludes.