During an overview of the current standard of care for patients with colorectal cancer (CRC), Tanios S. Bekaii-Saab, MD noted that as molecular testing becomes more important, researchers are looking into how to best personalize therapy for optimal outcomes. He spoke with CancerNetwork® as part of an Around the Practice® program focused on testing and treatment options for patients with metastatic CRC. 

When discussing the future direction of CRC care strategies, it is possible that treatment will be tailored to the individual based on mutation status, such as BRAF V600E, said Bekaii-Saab, leader of the Gastrointestinal Cancer Program and medical director of the Cancer Clinical Research Office, and vice chair and section chief for Medical Oncology in the Department of Internal Medicine at the Mayo Clinic. 

Bekaii-Saab noted that his institution is investigating select treatments in earlier lines of therapy, as chemotherapy plus or minus a biologic is the current standard of care. He also highlighted the importance of a multidisciplinary team approach, as he knows working with radiologists, and surgeons is important to provide patients with the best care. 

At the time of the interview, fruquinintib (Fruzaqla) was pending approval for patients with previously treated metastatic CRC. On November 8, 2023, fruquintinib was granted approval based on results from the phase 3 FRESCO-2 trial (NCT04322539).1,2 Investigators of the trial reported a median overall survival of 7.4 months (95% CI, 6.7-8.2) in the fruquintinib arm vs 4.8 months (95% CI, 4.0-5.8) in the placebo arm (HR, 0.66; 95% CI, 0.55-0.80; P <.0001).

Fruquintinib will now join trifluridine/tipiracil (Lonsurf) or regorafenib (Stivarga) as part of the second-line landscape and beyond for patients with previously treated CRC, Bekaii-Saab explained.

In closing, he stated that he is optimistic about the future of CRC treatment, as there is the potential for the development of new targeted therapies, immunotherapies, and gene editing therapies that will lead to more personalized and effective treatments for CRC patients.

 “The biggest takeaway from the discussion with my esteemed colleagues today relates to further understanding the complexities that have emerged with the availability of multiple targeted options in metastatic CRC,” he concluded.

1.     Takeda receives U.S FDA approval of Fruzaqla (fruquintinib) for previously treated metastatic colorectal cancer. News release. Takeda. November 8, 2023. Accessed November 8, 2023. https://bit.ly/3SwkD8U

2.     Dasari A, Lonardi S, Garcia-Carbonero R, et al. Fruquintinib versus placebo in patients with refractory metastatic colorectal cancer (FRESCO-2): an international, multicentre, randomised, double-blind, phase 3 study. Lancet. Published online June 15, 2023. doi:10.1016/S0140-6736(23)00772-9