{"doi":"10.6004/jnccn.2023.5012","title":"Updates in the Treatment of Metastatic Colorectal Cancer","abstract":"<jats:p>Molecular biomarker testing for all patients with metastatic colorectal cancer (CRC) has become increasingly important because identifying targetable alterations can lead to meaningful clinical benefits. At a minimum, testing should include <jats:italic>RAS</jats:italic>, <jats:italic>BRAF</jats:italic> mutational status, microsatellite instability status, <jats:italic>HER2</jats:italic> expression, <jats:italic>NTRK</jats:italic>, and <jats:italic>RET</jats:italic> mutations. For <jats:italic>HER2</jats:italic>-amplified cancer, the NCCN Guidelines offer multiple treatment options, including trastuzumab in combination with tucatinib or pertuzumab, and trastuzumab-deruxtecan. Combination trastuzumab + tucatinib has recently received approval by the FDA for refractory <jats:italic>RAS</jats:italic> wild-type, HER2-amplified CRC. The addition of bevacizumab to trifluridine/tipiracil treatment has significantly prolonged median overall survival compared with trifluridine/tipiracil alone, regardless of molecular subtypes. <jats:italic>KRAS</jats:italic> G12C–targeted therapies are on the horizon, with several agents in ongoing studies. Furthermore, bilevel blockade is important when addressing MAP kinase pathway alterations.</jats:p>","journal":"Journal of the National Comprehensive Cancer Network","year":2023,"id":619980,"datarank":0.3596842909197557,"base_score":2.3978952727983707,"endowment":2.3978952727983707,"self_citation_contribution":0.3596842909197557,"citation_network_contribution":0.0,"self_endowment_contribution":0.3596842909197557,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":897658,"name":"Katrina S. Pedersen","orcid":"0000-0003-2793-6901","position":1,"is_corresponding":false},{"id":260757,"name":"Aparna R. Parikh","orcid":"0000-0002-5245-7841","position":2,"is_corresponding":false},{"id":728193,"name":"Midhun Malla","orcid":"0000-0002-9969-588X","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Updates in the Treatment of Metastatic Colorectal Cancer","abstract":"<jats:p>Molecular biomarker testing for all patients with metastatic colorectal cancer (CRC) has become increasingly important because identifying targetable alterations can lead to meaningful clinical benefits. At a minimum, testing should include <jats:italic>RAS</jats:italic>, <jats:italic>BRAF</jats:italic> mutational status, microsatellite instability status, <jats:italic>HER2</jats:italic> expression, <jats:italic>NTRK</jats:italic>, and <jats:italic>RET</jats:italic> mutations. For <jats:italic>HER2</jats:italic>-amplified cancer, the NCCN Guidelines offer multiple treatment options, including trastuzumab in combination with tucatinib or pertuzumab, and trastuzumab-deruxtecan. Combination trastuzumab + tucatinib has recently received approval by the FDA for refractory <jats:italic>RAS</jats:italic> wild-type, HER2-amplified CRC. The addition of bevacizumab to trifluridine/tipiracil treatment has significantly prolonged median overall survival compared with trifluridine/tipiracil alone, regardless of molecular subtypes. <jats:italic>KRAS</jats:italic> G12C–targeted therapies are on the horizon, with several agents in ongoing studies. Furthermore, bilevel blockade is important when addressing MAP kinase pathway alterations.</jats:p>","is_dataset_classified":null,"base_score":2.302585092994046,"endowment":2.302585092994046,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"19767382","pmcid":null,"openalex_id":"https://openalex.org/W4379163345","authors":[],"funders":[],"total_grants":0,"fwci":1.0426,"citation_percentile":0.77093521,"influential_citations":0,"citation_trend":[{"year":2024,"count":9}],"oa_status":"bronze","license":null,"oa_locations":[{"url":"https://jnccn.org/downloadpdf/journals/jnccn/21/5.5/article-p567.pdf","host_type":"journal"},{"url":"https://jnccn.org/downloadpdf/journals/jnccn/21/5.5/article-p567.pdf","host_type":"publisher"},{"url":"https://jnccn.org/view/journals/jnccn/21/5.5/article-p567.xml","host_type":"publisher"},{"url":"https://doi.org/10.6004/jnccn.2023.5012","host_type":"journal"}],"fields_of_study":["Colorectal Cancer Treatments and Studies","Gastric Cancer Management and Outcomes","Cancer Research and Treatments"],"mesh_terms":[],"keywords":["Medicine","KRAS","Trastuzumab","Colorectal cancer","Pertuzumab","Oncology","Internal medicine","Microsatellite instability","Bevacizumab","Regorafenib","Cancer","Chemotherapy","Breast cancer","Microsatellite","Genetics"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-03T09:28:40.663482Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}