Clinical Pearls for Treating Metastatic Colorectal Cancer
Marwan G. Fakih, MD, and Atif Hussein, MD, MMM, FACP, conclude their discussion with advice for clinicians treating patients with 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.
Asked for final recommendations about the trifluridine/tipiracil and bevacizumab combination, Dr. Hussein emphasized the phase 3 SUNLIGHT trial data clearly demonstrate efficacy without needing complicated analysis. He would educate physicians on potential adverse effects like neutropenia, which likely caused the 12% discontinuation rate in the clinical trial setting. However, with appropriate growth factor support allowed in real-world practice, tolerance should improve. Likewise, properly advising the one week break in the 28-day treatment cycle facilitates intervening with growth factors.
Because oral therapies often encounter insurance obstacles, Dr. Hussein stressed the importance of enlisting pharmacists to facilitate approvals and affordability. Some oncologists may doubt rechallenging with bevacizumab in the third line so extensive education around the proven benefits is warranted. Avoiding underutilization will require highlighting the optimal administration schedule, proactively managing adverse effects, and securing financial assistance.
In closing, Dr. Fakih thanked Dr. Hussein for reviewing how the SUNLIGHT trial established trifluridine/tipiracil and bevacizumab as the clear standard of care in third-line metastatic colorectal cancer. While optimal adoption requires physician education on implementation strategies, the impressive survival data should provide strong motivation to learn proper administration, toxicity mitigation, and access support.
*Video synopsis is AI-generated and reviewed by Cancer Network editorial staff.
