Colon Cancer

Mai multe ca aceasta

Operating room

după gian frank capaquira calizaya

Veternarian

după Matt Witt

GYM

după Tariko hackshaw

Marfan Disease

după Christopher Pereira

Colon Cancer

last line agents

Regorafenib trifluridine - tipiracil

STAGE IV/Metastatic - all metastatic colorectal cancers should be geonotyped for RAS, BRAFV600, MSI/ MMR, HER2

5FU/LV capecitabine + bevacizumab cetuximab/panitumumab for KRAS WT, left side tumor nivolumab/pembrolizumab for dMMR/MSI-h only nivolumab + ipilmumab for dMMR/MSI-H only trastuzumab + (pertuzumab or lapatinib) or fam-trastuzumab deruxtecan for HER2+, RAS, BRAF WTG

If improved functional status -> use "fit for therapy" if no improve functional status -> supportive care

FOLFOX +/- bevacizumab (VEGF) CAPEOX +/- bevacizumab FOLFIRI +/- bevacizumab FOLFOX + (cetuximab/panitumumab)[EGFR] for KRAS WT (Nivolumab [PD1] + ipilimumab [CTLA4]) or pembrolizumab [PD1] for dMMR/MSI-H only

Switch from OX to IRI/ IRI to OX

Stage I, II, III

neoadjuvant therapy

surgery

Adjuvant therapy - begins 4-8 weeks after surgery for 3-6 months

FOLFIRI

Bolus 5FU + IV leucovorin + IV irinotecan + CIV 5FU for 46-48h

5FU/LV OR capecitabine

Stage III

5FU/LV

CAPEOX x3-6 months OR FOLFOX x6 months

CAPEOX x3 months OR FOLFOX x6 months

CAPEOX

capecitabine + oxaliplatin

FOLFOX

Bolus 5FU + IV leucovorin + oxaliplatin + CIV 5FU for 46-48h x 14 days

can be outpatient