mCRC Flashcards
Landmark Papers for mCRC and what they showed
1. EPOCH
- EPOCH (2021)
- decreased disease progression or death with second line chemo + Y90 vs. chemo alone
- Decreased hepatic disease progression or death with second line chemo +Y90 vs. chemo alone
- increased median TTP and median Hepatic TTP by 2.1 and 4.9 months
- ORR with chemo + Y90 better than chemo alone
were there any chemotherapy-related adverse events in the EPOCH study (chemo +y90 vs chemo alone)
no
what were the primary endpoints for the EPOCH study
Progression-free survival (PFS) and hepatic PFS
does Kras mutation have a better or worse prognosis in CRC
worse
EPOCH study
1. timing of y90
2. planning dose
3. Dosimetry method
4. glass or resin
- before second line therapy
- 120 Gy
- Single-compartment dosimetry
- Glass
weaknesses of EPOCH
- 13% did not receive TARE in the treatment arm
- imbalance in AE reporting due to additional visits associated with TARE
- Used RECIST instead of mRECIST criteria
- did not use personalized dosimetry
- bilobar treatments
did EPOCH or SIRFLOX-FOXFIRE show improvement in OS for treating right sided colon tumors
SIRFLOX-FOXFIRE
EPOCH did not yield PFS benefits for mets arising from a right-side colon tumor
mCRC tumors with Kras mutations are often resistant to which type of agents
anti-EGFR therapies
(cetuximab and panitumumab)
difference between capecitabine and 5-FU
capecitabine is a prodrug of 5-FU (gets metabolized to 5-FU)
what is FOLFOX
leucovorin calcium (folinic acid), fluorouracil, and oxaliplatin
what does leucovorin do
prevents folate deficiency
mechanism of action for cetuximab
Epidermal growth factor receptor inhibitor
what is FOLFIRI
leucovirin calcium, fluorouracil, Irinotecan
biomarkers to look out for in colorectal mets
- KRAS/NRAS
- BRAF
- MSI
- HER2
- NTRK/ALK
