International Perspectives in Individualizing Therapy Beyond Second-line Treatment for Colorectal Cancer

Tanios Bekaii-Saab, MD, FACP
Program Director
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Khalid Alsaleh, MD, FRCPC
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Svetlana I. Kutukova, MD, PhD
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Suayib Yalcin, MD
Released: March 8, 2018
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Introduction

Overview

In this noncertified educational activity, program chair Tanios Bekaii-Saab, MD, FACP, and faculty experts Khalid Alsaleh, MD, FRCPC; Svetlana I. Kutukova, MD, PhD; and Suayib Yalcin, MD, discuss international approaches to optimal case management of 5 different patients with progressive colorectal cancer (CRC) and review the latest evidence underlying their recommended therapeutic strategies. Case topics include:

  • Therapy options for progressive metastatic CRC
  • Management of adverse events associated with third-line treatment, including hand–foot skin reaction and febrile neutropenia
  • Treatment selection for progressive microsatellite instable (MSI) metastatic CRC
  • Management of BRAF-mutated metastatic CRC

Please note that the slide thumbnails embedded within this activity link to a complete PowerPoint slideset that can be found here or downloaded by clicking on any of the thumbnails within the activity.

For additional guidance on managing your individual patients with metastatic CRC, please use our Interactive Decision Support Tool, Focus on Metastatic Colorectal Cancer,” to enter your patient’s specific disease characteristics and learn how 5 US-based CRC experts would manage your case!

Clinical Care Options plans to measure the educational impact of this activity. Several questions in this activity will be asked twice, once at baseline and then once again after the discussion that informs the optimal choice. Your responses will be aggregated for analysis, and your specific responses will not be shared.

Before you begin, please take a moment to answer the following question.

Patient Case: Progressive Metastatic CRC

A 53-year-old man with 2 children in high school who works full-time seeks a second opinion on treatment options for progressive metastatic CRC. He was initially diagnosed with stage III CRC and was treated with 5-fluorouracil (5-FU). A year later, a single left RAS-mutated liver metastasis was resected and followed by treatment with 5-FU/leucovorin/oxaliplatin (FOLFOX) for 6 months, and the oxaliplatin was discontinued due to significant neuropathy. Six months later, he experienced disease progression in the liver that was treated with 5-FU/leucovorin/irinotecan (FOLFIRI) plus bevacizumab, followed by 10 months of bevacizumab plus 5-FU maintenance. His tumor is microsatellite stable.

His baseline absolute neutrophil count (ANC) is 1000 cells/μL and platelet count is 80 x 109/L. The patient needs to keep working as long as possible. He desires aggressive treatment that will prolong his life.
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