Colorectal Cancer   

Would you consider the BEACON regimen (i.e., encorafenib/binimetinib + cetuximab) in this setting?

What were your “top 3” presentations/studies coming out of the meeting this year and how will it impact your own clinical practice?

If you do not use prophylaxis, what skin care strategy do you employ?

Would you debulk with neoadjuvant therapy to achieve resectability?

Would you recommend 6 months of FOLFOX or just surveillance?

G1 neuropathy and G3 neutropenia were observed with cycle 12 FOLFOX + bev. Would you reintroduce oxali at a lower dose or switch to irinotecan+EGFRi ...

Of note - the tumor tissue biopsy NGS did not show KRAS or BRAF mutations. Microsatellite stable. Patient received first line FOLFOXIRI + Avastin .

This involves the primary site responding but progression with new bone marrow involvement with resulting cytopenias.

Colleagues in surgery have raised concerns about post radiation effects in the pelvis with the ordering of short course RT->chemo ->surgery.

eg LVI/PNI, poorly differentiated? If so, what regimen and for how long?

Is there a subset of patients you would avoid neoadjuvant CRT and operate first?

Benefit of oxaliplatin in patients >70 years of age is not proven and only 5FU/capecitabine in a MSI-H tumor is of questionable efficacy. What woul...

Would you use a small cell regimen over a more traditional FOLFOX-esque approach?

No high risk features such as: lymphovascular invasion, perforation, or involved margins

Do you use the same high risk factors as adenocarcinoma when deciding on adjuvant treatment for early stage disease?

Would you consider adjuvant chemotherapy?

Would you use FOLFIRINOX as in Prodige 23 or FOLFOX as in RAPIDO?

When would you consider use of ctDNA to help with this decision?

How would the sidedness of the tumor, BRAF, RAS,HER2 or MSI status affect your decision?

Would you consider using PARP Inhibitor in this situation? 

If so, which patients are the best candidates? 

Would you use dual agent chemotherapy such as FOLFIRI, combination of chemo with biologic- IRI/Cetux or all 3 drugs simultaneously? How would sidednes...

Would you continue to trend ctDNA to detect early recurrence?

Do you routinely test for this with a re-biopsy?

Given that majority of benefit is derived from the capecitabine, would this be an acceptable option to decrease patient contact with the healthcare sy...

If so, how much systemic therapy would you give before considering surgery? 

Would presence of features considered high risk in stage II sway your interpretation of the IDEA trial? 

Would you choose to use IO or BRAF directed therapy based on BEACON? Or would you continue to use cytotoxic chemotherapy?

Package insert indicates discontinuing bevacizumab in PE and there are no guidelines on re-challenging after acute clot is managed.

In practice, does starting with chemoradiation followed by chemotherapy result in a significant delay in initiating chemotherapy or a patient's abilit...

If so, what agent(s) would you consider given the concurrent amplification and mutation?

The German trial included patients with tumors up to 16cm from the anal verge, while the Swedish trial update found no local control benefit for tumor...

Would you approach with curative intent with locoregional treatment or systemic treatment alone?

Does the pathology outweigh usual staging and risk factors?

Instead of FOLFOXIRI and bevacizumab as per TRIBE trial

The NCCN seems to make its recommendation based on extrapolation from colon cancer, but those patients are not treated with pre-op chemoRT.

PDL1 is > 50%. There was no perforation or lymph node involvement.

Has the utility of BRAF in CRC expanded beyond guiding prognosis? Is there a role in non-metastatic CRC?

Does the presence of BRAF mutation affect your decision?

Do you test for COX-2 and PIK3CA mutations?

Are these patients better candidates for preop chemotherapy alone?

If a patient with stage II or III colon adenocarcinoma who presents to your clinic 12-16 weeks after surgical resection do you give adjuvant chemother...

Is there a change in approach over the past few years? Would there be a role for the 12-gene recurrence score?

Since some prior subset analyses have suggested that oxaliplatin may not improve outcomes of older patients with colon cancer in the adjuvant settin...

Does the recent Hopkins trial of pembrolizumab change your management of these patients?

If so, what is your preferred regimen?