Unmet Needs and Therapy Modifications Relevant in the CRC Landscape
John L. Marshall, MD, discusses unmet needs in the targeted therapy space and the importance of optimizing dosing in colorectal cancer.
John L. Marshall, MD, director of the Ruesch Center for the Cure of Gastrointestinal Cancers at Georgetown Lombardi Comprehensive Cancer Center in Washington, DC, discusses unmet needs in the targeted therapy space and the importance of optimizing dosing in colorectal cancer (CRC).
The main issue for patients with CRC is the lack of novel therapies and targets, according to Marshall. While some progress has been made with BRAF, HER2, and microsatellite instability–high [MSI-high] therapies offering additional options, many patients still lack effective treatments.
Marshall says physicians need to be well-informed about new agents and their optimal administration. Some physicians may change doses and schedules of drugs like trifluridine/tipiracil (Lonsurf), fruquintinib (Fruzaqla), and regorafenib (Stivarga). Modification of these regimens may lead to improved patient outcomes and quality-of-life increases, in Marshall’s opinion.
TRANSCRIPTION:
0:10 | The biggest issue we have for our patients is novel therapies [and] novel targets. The nice thing about these drugs is that there isn't a specific molecular subtype for them, but we have to remember that now, with BRAF and HER2 and MSI, those patients have additional choices. We are soon, hopefully going to have some RAS mutation targeted therapies in colon cancer, so this will be a big impact as well. But this still leaves a lot of patients who don't have those choices, or even patients with those choices who will need alternative approaches, so all of us need to be up to speed on these agents and how best to give them.
0:58 | To me, one of the most important components as an experienced CRC physician is I don't really like the approved doses and schedule of these drugs. So, for example, with [trifluridine/tipiracil], it's 2 weeks in a row and then 2 weeks off; I find that difficult to use, and so I just automatically go to every other week. I do some modifications sometimes with fruquintinib. We are all modifying regorafenib based on clinical trials. So I do think optimizing dose and schedule is an important component to get the best outcomes and improve patient quality of life.
