Targeted and immunotherapies for colorectal cancer
This section covers the following topics:
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)
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 ()|
|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 ()|
|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|
|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|
|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|
|Targets vascular endothelial growth factor (VEGF)||colorectal cancer||As a single agent for patients who have progressed after treatment with chemotherapy and||No required|
|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|
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.
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.