ASCO GUIDELINES Bundle

Late-Stage Colorectal Cancer

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24 Disclaimer is pocket guide is derived om recommendations in the American Society of Clinical Oncolog y Guideline. is resource is a practice tool based on ASCO ® practice guidelines and is not intended to substitute for the independent professional judgment of the treating physician. Practice guidelines do not account for individual variation among patients. is pocket guide does not purport to suggest any particular course of medical treatment. Use of the practice guidelines and this resource are voluntary. e practice guidelines and additional information are available at www.asco.org/resource-stratified-guidelines. Copyright ©2020 by American Society of Clinical Oncolog y. All rights reserved. Source E. Gabriela Chiorean, Govind Nandakumar, Temidayo Fadelu, Sarah Temin, Ashley Efrain Alarcon-Rozas, Suyapa Bejarano, Adina-Emilia Croitoru, Surbhi Grover, Pritesh V. Lohar, Andrew Odhiambo, Se Hoon Park, Erika Ruiz Garcia, Catherine Teh, Azmina Rose, Bassem Zaki, Mary D. Chamberlin. Treatment of Patients with Late-Stage Colorectal Cancer: ASCO Resource-Stratified Guideline. JCO Glob Oncol. 2020 March 9 doi: 10.1200/JGO.19.00367 106 Commerce Street, Suite 105 Lake Mary, FL 32746 TEL: 407.878.7606 • FAX: 407.878.7611 Order additional copies at GuidelineCentral.com Copyright © 2020 All rights reserved ASCOmCRC3203 ASCO believes that cancer clinical trials are vital to inform medical decisions and improve cancer care and that all patients should have the opportunity to participate. Additional information, which may include data supplements, slide sets, and other clinical tools and resources, is available at www.asco.org/resource-stratified-guidelines. Abbreviations anti-EGFR, anti-epidermal growth factor medical therapy; BRAF, BRAF (v-raf murine sarcoma viral oncogene homolog B1); CEA, carcinoembryonic antigen; CT, computed tomography; dMMR, deficient mismatch repair; EGFR, epidermal growth factor receptor; HAI, Hepatic arterial infusion; mCRC, metastatic colorectal cancer; MDT, multidisciplinary team; mRectal, metastatic rectal cancer; MRI, magnetic resonance imagining ; MSI, microsatellite instability; MSI-H, MSI high; MSI/MMR, microsatellite instability, MMR, mismatch repair genes; MUT, mutation (or mutated); N/A, not available; NACT, neoadjuvant chemotherapy; PET/CT, positron emission tomography/computed tomography; PS, performance status; RAS, RAS gene; SBRT, stereotactic body radiation therapy; SIRT, selective internal radiation therapy; TACE, trans-arterial chemoembolization; US, ultrasound; V600E, valine at amino acid 600; VEGF, vascular endothelial growth factor; WT, wild-type Recommendation Grading Type Benefit/harm Evidence Quality Strength of Recommendation EB Evidence- based B Benefits outweigh harms H High Strong FC Formal consensus H Harms outweigh benefits I Intermediate Moderate IC Informal consensus B/H Relative balance of benefits and harms L Low Weak Ins Insufficient

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