Treatment Options for Colorectal Cancer

EP: 1.Overview of Metastatic Colorectal Cancer (mCRC)

EP: 2.Metastatic Colorectal Cancer: Patient Presentation, Diagnosis, and Treatment

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EP: 3.Treatment Options for Colorectal Cancer

EP: 4.SUNLIGHT: Trifluridine-Tipiracil and Bevacizumab in Refractory mCRC

EP: 5.Outcomes from the SUNLIGHT Study in Metastatic Colorectal Cancer

EP: 6.Key Takeaways from the SUNLIGHT Study in mCRC

EP: 7.Evolving Colorectal Cancer Treatment Landscape

EP: 8.Clinical Pearls for Treating Metastatic Colorectal Cancer

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.

Dr Fakih summarized current best practices for stratifying metastatic colorectal cancer (mCRC) treatment by RAS/BRAF mutation status and primary tumor location. Unfortunately, as Dr Hussein noted, despite highly active initial regimens, nearly all patients eventually progress after 2 lines of therapy. At this point, until recently, the main third-line options were trifluridine/tipiracil and regorafenib, offering approximately 2 months of disease stabilization.

Before the phase 3 SUNLIGHT trial, Dr. Hussein managed expectations in third-line mCRC by focusing on quality of life and stabilization rather than response rates. Some patients who progressed after trifluridine/tipiracil or regorafenib could be re-challenged with initial therapies. But the SUNLIGHT trial has defined a new standard of care for third-line treatment.

To provide context, Dr Fakih explained that prior third-line options only showed an additional 2 months median overall survival benefit over best supportive care. Therefore, some patients opted for supportive care only after two lines of therapy, while others pursued early phase clinical trials.

In summary, Drs Fakih and Hussein explained that despite excellent initial response, nearly all patients with mCRC eventually progress after 2 lines of standard chemotherapy plus biological therapy. Until recently, third-line options provided limited benefit, but the promising results of the phase 3 SUNLIGHT trial support a new standard of care that both specialists expect may provide significantly improved outcomes for patients with refractory mCRC.

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