What are the European Society of Medical Oncology (ESMO) treatment guidelines for patients with metastatic colorectal carcinoma (mCRC)?

Updated: Apr 15, 2020
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

The 2016 European Society of Medical Oncology (ESMO) guidelines for the management of patients with mCRC concur with the ASCP/CAP/AMP/ASCO RAS mutational testing recommendations above. Additional recommendations include the following [167] :

  • Tumour  BRAF mutation status should be assessed alongside the assessment of tumour  RAS mutational status for prognostic assessment (and/or potential selection for clinical trials)
  • DPD testing before 5-FU administration remains an option but is not routinely recommended 

  • UGT1A1 phenotyping remains an option and should be carried out in patients with a suspicion of UGT1A1 deficiency as reflected by low conjugated bilirubin and in patients where an irinotecan dose of >180 mg/m2 per administration is planned 

  • TS activity and TSER genotyping are not recommended for use in clinical practice

  • ERCC1 expression for treatment decisions involving the use of oxaliplatin is not recommended outside of clinical trial


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