Using Biomarkers to Guide Treatment in Colorectal Cancer

Amber Draper, PharmD, BCOP, clinical pharmacist at Winship Cancer Institute discussed how biomarkers are used to make informed decisions in colorectal cancer treatment. 


Five years ago we knew that a lot of mutations existed, but we only knew how to target a few of those. We also didn’t know the big picture of how all these mutations interacted. And so now we kind of understand that when patients have different mutations and they have multiple mutations, how those can impact their prognosis and also their treatment. And so, we heavily rely on the biomarkers to direct what care a patient should receive up front and also in a second- and third-line setting.
Typically, we don’t test patients in the adjuvant setting, so again that’s more of a curative intent. We wait and do a lot of the biomarker testing when patients have metastatic disease. And the reason for that is that we still don’t really know what to do with these mutations in the adjuvant setting. So typically a majority of the tests are done by tissue testing, by PCR or IHC, if we’re talking about MSI-high testing, so more or less that’s how a lot of the testing is done.

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