Overview of Metastatic Colorectal Cancer (mCRC)

Opinion
Video

Marwan G. Fakih, MD, and Atif Hussein, MD, MMM, FACP, introduce themselves and give an overview of metastatic colorectal cancer (mCRC).

This is a synopsis of an Insights series featuring Marwan G. Fakih, MD, of City of Hope, and Atif Hussein, MD, MMM, FACP, of Memorial Healthcare System.

Marwan G. Fakih, MD, from City of Hope in Duarte, California welcomed Atif Hussein, MD, MMM, FACP, from Memorial Healthcare System in Hollywood, Florida to discuss findings from the SUNLIGHT phase 3 clinical trial evaluating trifluridine/tipiracil and bevacizumab compared to trifluridine/tipiracil alone in refractory metastatic colorectal cancer.

Dr Hussein emphasized the substantial morbidity and mortality burden of metastatic colorectal cancer, the second leading cause of cancer deaths with an anticipated 153,000 new colorectal cancer cases and 53,000 deaths in the U.S. this year. Alarmingly, diagnoses are increasing in patients under age 50, with 20,000 new cases and 4,000 deaths anticipated in this younger population. Consequently, the American Cancer Society recently lowered the recommended screening age for colonoscopy from 50 to 45 years. After declining 3% to 4% annually in the 2000s, colorectal cancer incidence has slowed to just a 1% annual decrease, likely related to diet and lifestyle factors.

Dr Fakih agreed, noting the sharp decline in colorectal cancer previously achieved through screening and colonoscopies is now threatened by rising incidence in younger patients not covered under screening recommendations. Frequently, when younger patients in their 30s present with concerning symptoms like rectal bleeding, they receive diagnoses like irritable bowel syndrome or hemorrhoids without further workup. Thus, it is imperative for primary care physicians to investigate these symptoms more thoroughly in younger patients instead of assuming benign etiologies.

The discussants clearly emphasized the pressing need to expand therapeutic options for metastatic colorectal cancer to confront rising incidence, especially in younger patients presenting outside routine screening protocols. Phase 3 clinical trials like SUNLIGHT evaluating novel targeted therapy combinations such as trifluridine/tipiracil and bevacizumab in refractory disease are essential to meet the needs of these patients with few remaining treatment alternatives.

*Video synopsis is AI-generated and reviewed by Cancer Network editorial staff.

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