Stage IV Therapies After Progression
In the previous videos, we discussed the initial management in the first and second line therapy for metastatic stage four colorectal cancer being mostly assembled by fluorouracil, irinotecan, oxaliplatin, and some combination and swapping of EGFR directed therapies like cetuximab and panitumumab, as well as a VEGF inhibitor like bevacizumab. But unfortunately with stage four, eventually people progress through all of these kind of initial backbone management strategies. There are options that exist after failure on these therapies, especially if that MMR status or MSI high status relating to immune therapy also is not an option, or you’ve progressed on immune therapy. Some of these agents are called regorafenib, trifluridine, tipiracil, otherwise known as TAS102, as well as some drugs in clinical trials that attack other actionable mutations that we don’t have as standard of care yet. These are drugs that you really want to carefully consider with your doctor because of the side effect profile and what may be going on with you individually.