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Targeted and Immunotherapies
Read about cancer treatment options listed by gene mutation, type of cancer and type of treatment.
Risk Management & Treatment > Cancer Treatment > By Cancer Type > Colorectal > Targeted and Immunotherapies
Targeted and immunotherapies for colorectal cancer
This section covers the following topics:
Immunotherapies
Immunotherapies help the body’s immune system detect and attack cancer cells.
- Immune checkpoint inhibitors are often used to treat advanced or colorectal cancer that have MSI-H or dMMR; usually after other treatments have been tried. The most common immune checkpoint inhibitors used for colorectal cancer are:
- Jemperli (dostarlimab)
- Keytruda (pembrolizumab)
- Opdivo (nivolumab)
- Yervoy (ipilimumab)
Targeted therapies
Several targeted therapies are used to treat advanced or colorectal cancer. Some work best for people with or without a certain .
- Anti VEGF therapies block tumors from forming blood vessels. Anti VEGF drugs used to treat colorectal cancer include:
- Avastin (bevacizumab)
- Cyramza (ramucirumab)
- Fruzaqla (fruquintinib)
- Zaltrap (ziv-aflibercept)
- Anti EGFR therapies slow down tumor cell growth. Anti EGFR drugs used to treat colorectal cancer include:
- Erbitux (cetuximab)
- Vectibix (panitumumab)
- BRAF inhibitors are oral medications that help slow down tumor growth in advanced colorectal cancers that test positive for the tumor called a BRAF V600E mutation. BRAF inhibitors are usually given in combination with other oral targeted drugs called MEK inhibitors (e.g., trametinib [Mekinist] or binimetinib [Mektovi]). BRAF inhibitors include:
- Tafinlar (dabrafenib)
- Braftovi (encorafenib)
- Stivarga (regorafenib) blocks several different types of proteins in the body that tumors use to grow. Stivarga may be used to treat colorectal cancer that has come back after treatment with other drugs.
- Herceptin (trastuzumab) and Tukysa (tucatinib) are used in combination for people with advanced colorectal cancer when tumor testing shows a called .
- Vitrakvi (larotrectinib) is approved for treatment of advanced cancers that have worsened with other treatments. It targets a genetic change called an NTRK fusion. This type of genetic change is found in a range of cancers, including some colon cancers.
Table of targeted and immunotherapies for colorectal cancer
| Name of drug | Type of agent | Cancer | Indication | |
|---|---|---|---|---|
| Herceptin (trastuzumab) and Tukysa (tucatinib) combination | or unresectable colorectal cancer | For people who progressed after chemotherapy | and RAS wild-type | |
| Jemperli (dostarlimab) | Immune checkpoint inhibitor | or unresectable colorectal cancer | For people who progressed after chemotherapy | High (MSI-H) or () |
| Keytruda (pembrolizumab) | Immune checkpoint inhibitor | or unresectable colorectal cancer | For treatment of or unresectable colorectal cancer | High (MSI-H) or () |
| or unresectable | For treatment of that have progressed after treatment and for which there are no other treatment options | High (MSI-H) or () | ||
| or unresectable | For the treatment of that have progressed after treatment and for which there are no other treatment options | High (TMB-H) | ||
| or unresectable colorectal cancer | Cancer that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan | High (MSI-H) or () | ||
| Opdivo (nivolumab) |
Immune checkpoint inhibitor | colorectal cancer |
As a single agent or in combination with Yervoy (ipilimumab) for cancer that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan |
High (MSI-H) or () |
| Yervoy (ipilumumab) | Immune checkpoint inhibitor | colorectal cancer | Combined with Opdivo (nivolumab) for cancer that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan | High (MSI-H) or () |
| Avastin (bevacizumab) |
Targets vascular endothelial growth factor (VEGF) | colorectal cancer | Combined with intravenous 5-fluorouracil-based chemotherapy for first- or second-line treatment | No required |
| colorectal cancer | In combination with chemotherapy for second-line treatment in patients who have progressed on a Avastin-containing regimen | No required | ||
| Cyramza (ramucirumab) |
Targets vascular endothelial growth factor (VEGF) | colorectal cancer | Combined with FOLFIRI chemotherapy, for treatment after disease progression on, or after prior therapy with bevacizumab, oxaliplatin, and a fluoropyrimidine | No required |
| Erbitux (cetuximab) |
Targets epidermal growth factor receptor (EGFR) | colorectal cancer | Combined with FOLFIRI for treatment, or combined with irinotecan for cancers that no longer respond to irinotecan-based chemotherapy or as a single agent in patients who have progressed after oxaliplatin- and irinotecan-based chemotherapy | EGFR positive and KRAS mutation negative |
| Fruzaqla (fruquintinib) |
Targets vascular endothelial growth factor (VEGF) | colorectal cancer | As a single agent for patients who have progressed after treatment with chemotherapy and | No required |
| Vectibix (panitumumab) |
Targets epidermal growth factor receptor (EGFR) | colorectal cancer | Combined with FOLFOX for treatment | Negative for KRAS and NRAS tumor mutations |
| colorectal cancer | As a single therapy following disease progression after prior treatment with fluoropyrimidine, oxaliplatin, and irinotecan-containing chemotherapy | Negative for KRAS and NRAS tumor mutations |
Last updated November 12, 2023
Related Resources
The following resources focus on colorectal cancer:
- FORCE colorectal cancer resources:
- Information: Colorectal cancer screening and prevention
- Information: Colorectal cancer treatment
- XRAY reviews: Colorectal cancer
- Video: What's New in Colorectal Cancer Treatment?
- Video: Colorectal Cancer Screening and Prevention in High-risk Individuals
- Video play list: Colorectal cancer
- Blog category: Colorectal cancer
- The American Cancer Society has a page which outlines the benefits and limitations of different types of colorectal cancer screening
- Colorectal Cancer Alliance is a nonprofit organization with a focus on colorectal cancer treatment, detection and prevention.
- The National Comprehensive Cancer Network has a free patient guide for people with colon cancer.
- The United Ostomy Association of America provides resources and support for people who have undergone surgery with an ostomy. .
- The Centers for Disease Control and Prevention's Colorectal Cancer Control Program provides grants to state departments of health to increase awareness and access to colorectal cancer screening.
updated: 12/21/2022
Paying For Care
Paying for cancer treatment
The majority of public and private health insurance plans are required to cover cancer diagnosis and treatment; copays, coinsurance and deductibles often apply. Patient costs and coverage for specific doctors, facilities or treatments may vary based on your health plan. Visit our section on Insurance and Paying for Care: Treatment for more information, links to sample appeal letters and other resources.
If you need information about finding an insurance plan, watch our video: Choosing Wisely: How to Pick Insurance Plans.
Some pharmaceutical companies have assistance programs that help cover the cost for their medications:
- Astellas Patient Assistance Program
- AstraZeneca Access 360
- Bayer US Patient Assistance Foundation
- Bristol-Myers Squibb Patient Assistance Foundation
- Eisai Patient Assistance Program
- Genentech Access Solutions
- GSK for You
- Janssen Patient Access Program
- LIlly Cares
- Merck Helps
- Pfizer Oncology Together
- Novartis Patient Assistance
- Sanofi Patient Connection
- Seattle Genetics' SeaGen Secure
- Taiho's Patient Support Program
- Takeda's Help at Hand
- Trodelvy Access Services
Organizations that offer co-pay assistance:
- Cancercare
- Patient Advocate Foundation
- Colorectal Cancer Alliance offers financial support to people in treatment for colorectal cancer.
Other resources:
- The American Cancer Society provides information and resources on covering the cost of cancer care. Public assistance, such as Medicaid may be available if you are ineligible for other programs.
- Needy Meds: Assistance programs to help patients with cost of medications and other healthcare.
- Triage Cancer offers tools and resources to help individuals cope with the financial aspects of a cancer diagnosis.
updated: 02/10/2023
Open Clinical Trials
The following are studies enrolling people with advanced colorectal cancer.
- NCT05328908: Comparing Three Drugs as Treatment for Individuals with Colorectal Cancer. This study is being done to evaluate the effectiveness of a combination of three drugs for the treatment of colorectal cancer in patients who have had at least one prior treatment.
- NCT05217446: Studying a Combination of Three Drugs to Treat Previously Untreated Colorectal Cancer with Certain Tumor Markers.This study is being done to learn about the effects of using three study medicines together as treatment for colorectal cancer that has been previously untreated.
- NCT03607890: Nivolumab and Relatlimab in Advanced MSI-H Cancers Resistant to Prior PD-(L)1 Inhibitor. The purpose of this study is to evaluate the safety, effectiveness, and tolerability of using the drugs nivolumab and relatlimab in patients with high (MSI-H) resistant to prior PD-(L)1 therapy.
- NCT05253651: Treatment of Colorectal Cancer as First Line Treatment in the Setting. This study is being done to learn if the drug Tukysa (tucatinib) combined with other cancer drugs works better than the standard of care treatment in people with colorectal cancer.
- NCT02997228: Chemotherapy, Bevacizumab, and/or Atezolizumab for / MSI-H Colorectal Cancer (COMMIT Study). The study will compare how well a combination of chemotherapy and works compared with an drug alone.
- NCT04008030: Nivolumab, Nivolumab Plus Ipilimumab, or Chemotherapy for High (MSI-H) Colorectal Cancer.The study will compare the combination of agents nivolumab (Opdivo) plus ipilimumab (Yervoy) in patients who have MSI-H or colorectal cancer versus using nivolumab alone or chemotherapy.
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NCT04895722: Combined Pembrolizumab & Quavonlimab (MK-1308A) Versus Other Treatments in People With or Stage IV Colorectal Cancer. The purpose of this study is to look at the safety of a combination drug pembrolizumab/quavonlimab compared with four other treatments in patients with Microsatellite Instability-High (MSI-H) advanced colorectal cancer.
A number of other clinical trials for patients with colorectal cancer can be found here.
updated: 11/12/2023