Managing mCRC

CE / CME

Opportunities and Challenges in Management of Metastatic Colorectal Cancer

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

Nurse Practitioners: 1.00 Nursing contact hours, includes 1.00 hour of pharmacotherapy credit

Released: May 02, 2023

Expiration: May 01, 2024

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Introduction

Colorectal cancer (CRC) is both common and deadly: It is the third most frequently diagnosed cancer in the United States and the third leading cause of cancer death in both men and women.1 Of note, although the incidence of new cases overall has been decreasing during the past 2 decades, the number of new cases among patients aged younger than 50 years has increased by 1.5% annually in the past few years.2 Although the causes of this trend are still being studied, it is likely associated with increasing rates of obesity, physical inactivity, and metabolic syndrome among younger individuals. The increase in early-onset CRC led the US Preventive Services Task Force to update its recommendation for colon cancer screening to begin at the age of 45 years instead of the previous 50 years of age.3 The estimated 5-year overall survival (OS) rate for patients diagnosed with any-stage CRC has increased from 50% to 65% in the past 50 years, but the 5-year OS rate for those with metastatic CRC (mCRC) is only 14% as of today.1 

The recommended initial workup for suspected CRC includes colonoscopy; complete blood count; chemistry profile including liver function tests; the tumor marker carcinoembryonic antigen; a CT scan of the chest, abdomen, and pelvis; and a biopsy via colonoscopy or at a metastatic site. With the proliferation of targeted therapies, molecular biomarker testing must be conducted to help guide treatment decisions.4,5 

Which of these biomarkers should be assessed in all patients newly diagnosed with CRC, independent of stage?