How Personalized Medicine May Impact Gastrointestinal Cancer Treatment

In an interview with CURE, Dr. Valerie Lee discussed emerging targeted therapies and personalized medicine approaches that are showing promise for gastrointestinal cancers and how they might impact a patient’s treatment plans.

Lee is a medical oncologist with the Johns Hopkins Sidney Kimmel Cancer Center at Sibley Memorial Hospital in Washington, D.C.

Lee discussed the significance of recent development of molecular testing and the ability to find patients’ specific, targetable mutations. She noted, for example, that among patients with colorectal cancer, approximately 2% of those are known to have HER2 mutations and another 3% to 5% are known to have BRAF mutations.

“These are really cool things that have changed how we're going to be able to manage colorectal cancer,” Lee said.

Transcript:

I think one of the cool developments over the past decade is molecular testing and the ability to find more of these specific targetable mutations. Unfortunately, historically, the technology to find the mutations has been more advanced than our ability to actually find the drugs to target them.

But for colorectal cancer, I think the very cool thing has been that while historically, we really only used cytotoxic therapy, there are small subgroups that we have been able to identify and for whom we have been able to develop targeted therapies. For example, about 2% of patients have HER2 mutations, and we are able to treat those patients with HER2-directed therapy. Then another 3% to 5% have BRAF mutations. These are cool findings that have changed how we're going to be able to manage colorectal cancer, even from the very beginning, although some of these therapies are used in later lines of treatment.

But I think the interesting area that's being developed and hasn't yet been approved, still going through phase 1 and 2 trials, is for KRAS inhibitors, particularly for the G12D mutation. This represents a huge group of our patients with colorectal cancer, and we are really excited about the data that is emerging and has been actively in progress. If we achieve success with these inhibitors, that would impact about 40% of our patients over time.

Transcript has been edited for clarity and conciseness.

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