Genomics May Reclassify Disease in Patients With Colorectal Cancer

Tanios S. Bekaii-Saab, MD, consultant, Division of Hematology/Oncology, Department of Internal Medicine, Mayo Clinic, discusses genetic testing and emerging precision medicine strategies in the field of colorectal cancer (CRC).

As part of the Academic and Community Cancer Research United (ACCRU) research consortium, multiple clinical trials are using genetic information obtained from roughly 6,000 patients with CRC across 16 centers. The study known as COLOMATE utilizes both liquid and tissue biopsy to identify genetic alterations in patients with CRC, say Bekaii-Saab. Other research includes the PULSE study (NCT03992456) of panitumumab (Vectibix), regorafenib (Stivarga), or TAS-102 (Lonsurf) as treatment of patients with metastatic and/or unresectable RAS wild-type disease. Finally, the MOUNTAINEER study (NCT03043313) of tucatinib trastuzumab in patients with HER2-positive disease is also underway as part of ACCRU. Presentations on these studies occurred during the 2021 Gastrointestinal Cancers Symposium.

Outside of these studies, Bekaii-Saab says there are basket trials that cover EGFR-mutated CRC, MET-mutated disease, as well as KRAS G12C-mutated disease. The hope is that the landscape continues to expand and CRC will become classified as multiple diseases based on the genetic alterations found in patients.