Targeting Molecular Subsets in Metastatic Colorectal Cancer (dMMR, - - PowerPoint PPT Presentation

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Targeting Molecular Subsets in Metastatic Colorectal Cancer (dMMR, - - PowerPoint PPT Presentation

Targeting Molecular Subsets in Metastatic Colorectal Cancer (dMMR, HER2, or BRAF V600E): Is it Time for Frontline Targeted Therapy? Benjamin A. Weinberg, M.D. Assistant Professor of Medicine Lombardi Comprehensive Cancer Center Georgetown


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Targeting Molecular Subsets in Metastatic Colorectal Cancer (dMMR, HER2, or BRAF V600E): Is it Time for Frontline Targeted Therapy?

Benjamin A. Weinberg, M.D. Assistant Professor of Medicine Lombardi Comprehensive Cancer Center Georgetown University

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The Colorectal Cancer Story

Weinberg BA et al. Clin Adv Hematol Oncol 2016. de Gramont A et al. J Clin Oncol 2000. Hurwitz H et al. N Engl J Med 2004. Douillard JY et al. J Clin Oncol 2010. Souglakos J et al. Br J Cancer 2006. Van Cutsem E et al. J Clin Oncol 2011. Falcone A et al. J Clin Oncol 2007. Cremolini C et al. Lancet Oncol 2015.

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Right vs. Left Colon vs. Rectum

Salem et al. Oncotarget 2017.

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IMMUNOTHERAPY FOR dMMR

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Response to Pembrolizumab Limited to MSI-H Tumors

Le et al. N Engl J Med 2015.

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Best Reduction in Target Lesion: All Patients

Presented By Michael Overman at 2018 Gastrointestinal Cancers Symposium

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Best Reduction in Target Lesions

Presented By Thierry Andre at 2018 Gastrointestinal Cancers Symposium

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Progression-Free and Overall Survival

Presented By Thierry Andre at 2018 Gastrointestinal Cancers Symposium

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Safety Summary

Presented By Thierry Andre at 2018 Gastrointestinal Cancers Symposium

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Presented By Neil Segal at 2018 ASCO Annual Meeting

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HER2-DIRECTED THERAPY

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Sartore-Bianchi et al. Lancet Oncol 2016.

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Sartore-Bianchi et al. Lancet Oncol 2016. Siravegna et al. Clin Cancer Res 2019.

ORR 30%

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MyPathway: Trastuzumab + Pertuzumab

Meric-Bernstam et al. Lancet Oncol 2019.

ORR 32%

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Meric-Bernstam et al. Lancet Oncol 2019.

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Raghav et al. ASCO AM 2018. Strickler et al. ASCO AM 2017.

CETIRI MOUNTAINEER: Trastuzumab + Tucatinib

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BRAF-TARGETED THERAPY

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BRAF Mutations Carry a Poor Prognosis

Cremolini et al. Lancet Oncol 2015.

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Introduction

Presented By Scott Kopetz at 2017 ASCO Annual Meeting

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Study Design

Presented By Scott Kopetz at 2017 ASCO Annual Meeting

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Primary Endpoint: Progression-free survival

Presented By Scott Kopetz at 2017 ASCO Annual Meeting

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Secondary Endpoint: Overall Survival

Presented By Scott Kopetz at 2017 ASCO Annual Meeting

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BEACON CRC

Kopetz et al. ESMO GI 2019.

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Kopetz et al. NEJM 2019.

BEACON CRC

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ORR 26% ORR 20% ORR 2%

Kopetz et al. NEJM 2019.

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Questions?

  • baw12@gunet.georgetown.edu
  • @benweinbergmd