ESMO 2022 | Overcoming acquired resistance to targeted therapy in colorectal cancer

Andrea Sartore-Bianchi, MD, ASST Great Niguarda Metropolitan Hospital, Milan, Italy, discusses overcoming resistance to targeted therapy in colorectal cancer (CRC). Acquired resistance is the principle issue with resistance to targeted therapies, the onset of which can be monitored via circulating tumor DNA (ctDNA). Targeted inhibition of EGFR with monoclonal antibodies is the standard of care for metastatic CRC (mCRC) in patients without RAS pathway mutations, however, acquired resistance is inevitable, predominantly due to RAS pathway alterations. The Phase II CHRONOS (NCT03227926) trial evaluated rechallenging with panitumumab RAS wild type mCRC patients with circulating tumor DNA (ctDNA)-confirmed secondary resistance to anti EGFR treatment. The CHRONOS trial demonstrated ctDNA can be used to efficiently guide anti-EGFR rechallenge therapy with panitumumab in patients with mCRC. This interview took place at the European Society for Medical Oncology (ESMO) 2022 Congress in Paris, France.