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Gastrointestinal Cancer

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A 56-year-old Caucasian woman presented to her primary care physician with a 3-month history of intermittent bright red rectal blood with defecation. At her initial visit, a digital rectal examination, anoscopy, and a pelvic examination with DNA testing for high-risk HPV were performed; all results were negative. She was referred for a colonoscopy, which revealed an abnormal area with a 3 × 4–cm mass in the rectum at a distance of 10 cm from the anal verge.

Anti-EGFR therapy is a valuable addition to the armamentarium of treatment options for patients with metastatic colorectal cancer. However, RAS mutation status is an imperfect biomarker for prediction of therapeutic outcomes in this setting. The recent discovery of tumor sidedness as a predictor of response highlights how little we understand about which patients are the most appropriate to receive drugs that target EGFR.