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Expert Point of View: Richard L. Schilsky, MD, FACP, FSCT, FASCO


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Richard L. Schilsky, MD, FACP, FSCT, FASCO, ASCO’s Chief Medical Officer and a gastrointestinal oncologist himself, was pleased to see the TAPUR study bearing fruit among patients with metastatic colorectal cancer. “Colorectal cancer is a very common disease, but we have not made much progress in treating it over the past 20 years…. Benefits over time have been only incremental. The whole field has been fairly stagnant,” he noted.

Richard L. Schilsky, MD, FACP, FSCT, FASCO

Richard L. Schilsky, MD, FACP, FSCT, FASCO

Dr. Schilsky hopes that TAPUR can spur progress by supporting and even igniting research into novel therapies. He found the data for cobimetinib/vemurafenib in BRAF-mutated tumors to be “compelling,” especially since encouraging outcomes were found in a heavily pretreated population (as opposed to the first-line BEACON trial of a targeted doublet).1 “Most patients in TAPUR had received at least three prior lines of treatment, and yet we saw a fairly high disease control rate (57%) and also had some patients stay on treatment for long periods of time,” he said (for three patients, treatment duration was 40 months).

Commenting on HER2-directed therapy in patients with HER2 amplification, he said the study’s data (25% response rate) nearly replicate the response rate of about 30% shown in Genentech’s My Pathway trial—but in a more advanced population. “I think we will see, in colorectal cancer, that there will be an opportunity to test for HER2 amplification and treat those patients with HER2-directed therapy.”

“We are excited to see these results in colorectal cancer,” Dr. Schilsky said, adding that he hopes these and other findings will encourage more clinicians to enroll their patients in TAPUR. ν

DISCLOSURE: Dr. Schilsky has received institutional research funding from ­AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Genentech/Roche, Lilly, Merck, and Pfizer; and has been reimbursed for travel, accommodations, or other expenses by Varian.

REFERENCE

1. Kopetz S, Grothey A, Van Cutsem E, et al: Encorafenib plus cetuximab with or without binimetinib for BRAF V600E-mutant metastatic colorectal cancer: Quality-of-life results from a randomized, three-arm, phase III study vs the choice of either irinotecan or FOLFIRI plus cetuximab (BEACON CRC). 2020 Gastrointestinal Cancers Symposium. Abstract 8. Presented January 25, 2020.

 


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