How do you manage a recurrence of colon cancer within 3-4 months of completion of adjuvant FOLFOX?
Do you add VEGFR/EGFR antibodies? Or switch to another regimen?
Answer from: Medical Oncologist at Academic Institution
I think the critical point here is NGS panel done quickly and used to judge your next step. For example, your approach would be different for KRAS mutated cancers vs BRAF V600E mutated cancers, etc. Generally, you would choose a non-FOLFOX regimen for relapse this soon after completion. This is a ve...
Answer from: Medical Oncologist at Academic Institution
I totally agree with Dr. @LoConte's answer.
Given the short disease free interval from completion of FOLFOX adjuvant treatment, most of us would consider this an oxaliplatin-resistant disease. So NGS test should be done to help guide treatment and irinotecan-based systemic treatment woul...
The only caveat would be the single potentially resectable recurrence. Also, I obtain NGS at the time of initial diagnosis so that the information is available immediately at the time of recurrence without the delay of waiting for results. How often do mutations change during the course of disease?