colorectal cancer

Colorectal cancer is the third most common cancer worldwide, with clinical trials now stratified by molecular profile — RAS/BRAF status, microsatellite instability (MSI-H/dMMR), and HER2 amplification define distinct therapeutic tracks. The approval of pembrolizumab as first-line standard of care for MSI-H metastatic colorectal cancer demonstrated that immunotherapy can achieve durable, often complete responses in a molecularly defined subgroup, transforming the research landscape.

Active trials investigate KRAS G12C and G12D inhibitors in combination with anti-EGFR agents, adagrasib plus cetuximab, anti-EGFR rechallenge guided by circulating tumor DNA, liver-directed therapies for oligometastatic disease (including stereotactic radiotherapy), and HIPEC (hyperthermic intraperitoneal chemotherapy) for peritoneal metastasis. Localized disease trials focus on neoadjuvant immunotherapy to enable organ preservation in rectal cancer.

Molecular testing — KRAS, NRAS, BRAF V600E, MSI status, HER2, and NTRK — is now standard before enrollment in most metastatic colorectal cancer trials.

Frequently Asked Questions — colorectal cancer Clinical Trials