Colorectal cancer stage 4

The theme for today appears to be friendship. The partner drug matters in chemotherapy.

1. Cetuximab works best with infusional 5FU, not bolus

2. OS and PFS benefit of avastin is when partnered with irinotecan

3. Oxaliplatin based chemo should be discontinued after 3-4 months of treatment i.e before onset of significant neurotoxicity

4. HER 2 amplified mCRC tend to do worse even if RAS WT.

5. Pertuzumab with trastuzumab induces 30% ORR, mostly stable disease or partial response. Another option is Enhertu.

6. Enhertu is holding its own: in the DESTINY CRC-01 trial 45% of heavily pretreated patients with HER2-positive (3+ IHC) colorectal cancer responded to this single agent, and 83% achieved disease control