Colorectal cancer Flashcards
When is adjuvant chemoradiotherapy indicated in CRC?
High risk stage 2, stage 3
3 months as good as 6 months
When is mAb therapy indicated in CRC?
Metastatic disease
Which mAbs are used in CRC?
Anti-VEGF (bevacizumab)
Anti-EGFR (cetuximab, panitumumab)
What mutation in CRC confers resistance to anti-EGFR therapy?
RAS/RAF mutation, Her2 mutation
What is bevacizumab?
mAb against VEGF-A
What class of drugs does 5-FU belong to? How does it work?
Fluoropyrimidine, inhibits thymidine synthesis
True or false:
In CRC, BRAF mutation carries a poorer prognosis.
True - associated with rapid chemo resistance and nodal spread
What are the two most common sites of metastatic spread in CRC?
Liver, lung
True or false:
Right sided CRC are more likely to involve a BRAF mutation
True
True or false:
Right sided CRC carry a better prognosis than left sided CRC.
False
In a patient who has undergone resection of a stenosing CRC, what is the indication for post operative colonoscopy?
To assess for synchronous cancer, as could not assess full length of bowel pre op
What is cetuximab?
mAb against EGFR
What is the mainstay of treatment for oligometastatic colorectal cancer?
Aggressive surgical approach + chemo
What is the mainstay of treatment for advanced metastatic CRC?
Palliative chemotherapy (5-FU based) + targeted mAb
