metastatic colorectal cancer

Updated: November 14, 2022

Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

bevacizumab

In combination with fluorouracil chemotherapy:

Solution

Intravenous (IV)

every 2 weeks

(in combination with bolus-IFL (irinotecan, 5-FU, leucovorin))
IV:10mg/kg every two weeks (in combination with FOLFOX4)

encorafenib

encorafenib, in combination with cetuximab, is used for the treatment of metastatic colorectal cancer. The oral dose given in the case is 300 mg four times daily.
Dose Modifications:
Discontinue encorafenib, if ceftuximab is discontinued.
1st dose reduction: 225 mg orally each day
2nd dose reduction: 150 mg orally each day
Subsequently, discontinue the dose permanently if unable to tolerate more than 150 mg/day

nivolumab

It is indicated as a single agent or in combination with ipilimumab.
For <12 years: Safety and efficacy are not seen
For ≥12 years:
Single-agent
<40 kg: 3 mg/kg intravenously every 2 weeks
≥40 kg: 240 mg intravenously every 2 weeks or 480 mg intravenously every 4 weeks
Continue until disease progression or unacceptable toxicity.
Combination with ipilimumab
nivolumab 3 mg/kg intravenously every 3 weeks with ipilimumab 1 mg/kg intravenously on the same day for 4 doses
After completing the combination therapy: Administer nivolumab 3 mg/kg intravenously every 2 weeks.
Continue until disease progression or unacceptable toxicity.