Areas of Controversy in the Treatment Landscape of mCRC

Michael A. Choti, MD, chief of surgery at MD Anderson Cancer Center, discusses some controversial topics he sees in the treatment landscape of metastatic colorectal cancer (mCRC).

When metastases in patients with mCRC can potentially be resected, Choti says patients may still be offered a curative intent therapy over a surgical resection of the primary tumor. When there is a limited number of lung metastases or liver metastases in a patient, surgical therapy to resect those sites of disease should be offered.

Another area of controversy includes sequencing treatment in these patients, whether you are using chemotherapy, liver surgery, chemoradiation therapy, or rectal surgery. Choti says the sequence of treatment can become very complex. The best management will rely on a multidisciplinary team including a medical oncologist, radiation oncologist, liver surgeon, colorectal surgeon, as well as high-quality imaging. These are all important components to achieving an optimal outcome.