• Am J Manag Care · May 2024

    Sequencing considerations in the third-line treatment of metastatic colorectal cancer.

    • Afsaneh Barzi and Tanios Bekaii-Saab.
    • Mayo Clinic, 5881 East Mayo Boulevard, Phoenix, AZ, 85054. Email: bekaii-saab.tanios@mayo.edu.
    • Am J Manag Care. 2024 May 1; 30 (2 Suppl): S31S35S31-S35.

    AbstractNumerous advances in the standard of care for metastatic colorectal cancer (mCRC), including the approval of several new treatments indicated for treatment in the third line or later (3L+), have been made, yet data and appropriate guidance on the optimal sequencing and treatment strategies for these lines of therapy are lacking. Four treatments-regorafenib, trifluridine/tipiracil alone or with bevacizumab, and fruquintinib-are FDA-approved and recommended by the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for the treatment of mCRC in the 3L+. When considering sequencing of treatment options for patients in the 3L+, the goal of treatment is to improve survival, but also maintain quality of life, a goal that requires consideration of relative efficacy and cumulative toxicity such as persistent myelosuppression.

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