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ESMO 2023 | MOUNTAINEER: impact of genomic alterations on tucatinib plus trastuzumab activity in mCRC

John H. Strickler, MD, Duke Cancer Institute, Durham, NC, reports on the Phase II MOUNTAINEER (NCT03043313) trial, which evaluated the activity and tolerability of tucatinib plus trastuzumab for patients with HER2+ metastatic colorectal cancer (mCRC). The trial led to approval of the regimen by the Food and Drug Administration (FDA). Dr Strickler discusses the results of an exploratory analysis of the trial which investigated genomic alterations that may predict sensitivity or resistance to the regimen. The results showed that patients with higher HER2 amplification levels had a higher clinical response rate. Additionally, genomic testing revealed mutations and amplifications in key genes like ERBB2, PIK3CA, APC, and TP53, but the clinical efficacy of tucatinib plus trastuzumab remained consistent in these patients. This analysis suggests that tucatinib plus trastuzumab is effective in patients with HER2+ RAS-WT mCRC, even when they have additional genomic alterations. This interview took place at the European Society for Medical Oncology (ESMO) 2023 Congress in Madrid, Spain.

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