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Ref Type | Journal Article | ||||||||||||
PMID | (37236086) | ||||||||||||
Authors | Yoshino T, Cervantes A, Bando H, Martinelli E, Oki E, Xu RH, Mulansari NA, Govind Babu K, Lee MA, Tan CK, Cornelio G, Chong DQ, Chen LT, Tanasanvimon S, Prasongsook N, Yeh KH, Chua C, Sacdalan MD, Sow Jenson WJ, Kim ST, Chacko RT, Syaiful RA, Zhang SZ, Curigliano G, Mishima S, Nakamura Y, Ebi H, Sunakawa Y, Takahashi M, Baba E, Peters S, Ishioka C, Pentheroudakis G | ||||||||||||
Title | Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with metastatic colorectal cancer. | ||||||||||||
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Abstract Text | The European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with metastatic colorectal cancer (mCRC), published in late 2022, were adapted in December 2022, according to previously established standard methodology, to produce the Pan-Asian adapted (PAGA) ESMO consensus guidelines for the management of Asian patients with mCRC. The adapted guidelines presented in this manuscript represent the consensus opinions reached by a panel of Asian experts in the treatment of patients with mCRC representing the oncological societies of China (CSCO), Indonesia (ISHMO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO), co-ordinated by ESMO and the Japanese Society of Medical Oncology (JSMO). The voting was based on scientific evidence and was independent of the current treatment practices, drug access restrictions and reimbursement decisions in the different Asian countries. The latter are discussed separately in the manuscript. The aim is to provide guidance for the optimisation and harmonisation of the management of patients with mCRC across the different countries of Asia, drawing on the evidence provided by both Western and Asian trials, whilst respecting the differences in screening practices, molecular profiling and age and stage at presentation, coupled with a disparity in the drug approvals and reimbursement strategies, between the different countries. |
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Molecular Profile | Indication/Tumor Type | Response Type | Therapy Name | Approval Status | Evidence Type | Efficacy Evidence | References |
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BRAF V600E | colorectal cancer | sensitive | Cetuximab + Encorafenib | Guideline | Actionable | Braftovi (encorafenib) in combination with Erbitux (cetuximab) is included in the Pan-Asian Guidelines Adaptation (PAGA) as a second- or subsequent-line therapy for patients with advanced or metastatic colorectal cancer harboring BRAF V600E (PMID: 37236086; ESMO.org). | detail... 37236086 |
MLH1 negative | colorectal cancer | sensitive | Pembrolizumab | Guideline | Actionable | Keytruda (pembrolizumab) is included in the Pan-Asian Guidelines Adaptation (PAGA) as first-line therapy for patients with advanced or metastatic colorectal cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (PMID: 37236086; ESMO.org). | detail... 37236086 |
MLH1 negative | colorectal cancer | sensitive | Ipilimumab + Nivolumab | Guideline | Actionable | Yervoy (ipilimumab) in combination with Opdivo (nivolumab) is included in the Pan-Asian Guidelines Adaptation (PAGA) as a second-line therapy for patients with advanced or metastatic colorectal cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) who progressed on first-line chemotherapy (PMID: 37236086; ESMO.org). | 37236086 detail... |
MSH6 negative | colorectal cancer | sensitive | Pembrolizumab | Guideline | Actionable | Keytruda (pembrolizumab) is included in the Pan-Asian Guidelines Adaptation (PAGA) as first-line therapy for patients with advanced or metastatic colorectal cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) (PMID: 37236086; ESMO.org). | detail... 37236086 |
MSH6 negative | colorectal cancer | sensitive | Ipilimumab + Nivolumab | Guideline | Actionable | Yervoy (ipilimumab) in combination with Opdivo (nivolumab) is included in the Pan-Asian Guidelines Adaptation (PAGA) as a second-line therapy for patients with advanced or metastatic colorectal cancer with high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) who progressed on first-line chemotherapy (PMID: 37236086; ESMO.org). | detail... 37236086 |