Recognizing How Treatment Differs in Community Setting for CRC

John L. Marshall, MD, chief of Hematology and Oncology, professor of Medicine and Oncology, and director of the Ruesch Center for the Cure of Gastrointestinal Cancers at Georgetown Lombardi Comprehensive Cancer Center in Washington, DC, discusses differences in treating colorectal cancer he observed among participants at a Case-Based Roundtable event he moderated.

Marshall emphasizes the complexity of staying updated with various cancers and treatments, the diverse knowledge bases among event participants, and the importance of understanding data application for patient care.

There are varying strategies in colorectal cancer treatment, from aggressive to strategic use of the approved drugs. The exchange covered gene profiles, performance status, age, and comorbidities, which all make an impact on treatment decisions. The full utilization of new drugs by community oncologists is key, rather than using the older, more familiar regimens, says Marshall.

TRANSCRIPTION

0:10 | We have to remember that it's very difficult today to be a general oncologist. There is so much information in all of the different cancers. It's even pretty difficult to be a specialized oncologist to keep track of everything. What struck me was the sort of differences in knowledge base that people had, that the attendees had, about the various data results and [adverse events] and management and this kind of thing. So I think one of the best takeaways is that people left with a more base, fundamental understanding of these data and how best to apply them to the patients in front of them.

0:51 | I think one of the biggest things that came out is just how different people's strategies are in using the medicines in colorectal cancer. Some are very intense and keep using the medicines until they burn the patient out, if you will. Others play a more subtle chess game, using the medicines to their optimum and then pulling back and reusing at a later time. There's more than one way to play chess, there's more than one way to strategize, and a lot depends on the opponent across from you, and so we talked a lot about the different gene profiles…and how those impact decision making and drug choices.

1:37 | We talked a lot about performance status and age and comorbidities, because I do think that a lot of the community oncologists out there fail to use all of these new medicines because they don't feel like they're really worth it. And I think we left this meeting with [changed] opinions by everybody that, in fact, we want to make sure and not leave them on the table.