Controversies in the treatment of RAS wild-type metastatic colorectal cancer

• R. Vera ^[1] ; M. Salgado ^[2] ; M.J. Safont ^[3] ; J. Gallego ^[4] ; E. González ^[5] ; E. Élez ^[6] ; E. Aranda ^[7]
  1. [1] Gobierno de Navarra

     Gobierno de Navarra

     Pamplona, España

     
  2. [2] Complexo Hospitalario Universitario de Ourense

     Complexo Hospitalario Universitario de Ourense

     Ourense, España

     
  3. [3] Hospital General Universitario de Valencia

     Hospital General Universitario de Valencia

     Valencia, España

     
  4. [4] Hospital General Universitario de Elche

     Hospital General Universitario de Elche

     Elche, España

     
  5. [5] Hospital Universitario Virgen de las Nieves

     Hospital Universitario Virgen de las Nieves

     Granada, España

     
  6. [6] Institute of Oncology Ljubljana

     Institute of Oncology Ljubljana

     Eslovenia

     
  7. [7] Medical Oncology Department, Maimonides Institute of Biomedical Research (IMIBIC), Hospital Reina Sofía, Córdoba

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 23, Nº. 4, 2021, págs. 827-839
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Objective To provide guidance for the management of RAS wild-type (wt) metastatic colorectal cancer (mCRC) in daily practice.

    Methods Nominal group and Delphi techniques were used. A steering committee of seven experts analyzed the current management of RAS wt mCRC, through which they identified controversies, critically analyzed the available evidence, and formulated several guiding statements for clinicians. Subsequently, a group of 30 experts (the expert panel) was selected to test agreement with the statements, through two Delphi rounds. The following response categories were established in both rounds: 1 = totally agree, 2 = basically agree, 3 = basically disagree, 4 = totally disagree. Agreement was defined if ≥ 75% of answers were in categories 1 and 2 (consensus with the agreement) or 3 and 4 (consensus with the disagreement).

    Results Overall, 71 statements were proposed, which incorporated the following areas: (1) overarching principles; (2) tumor location; (3) triplets; (4) maintenance; (5) second-line and beyond treatments; (6) Rechallenge and liquid biopsy. After the two Delphi rounds, only six statements maintained a lack of clear consensus.

    Conclusions This document aims to describe the expert’s attitude when dealing with several common clinical questions regarding patients with RAS wt mCRC.