14
Table 5. First-Line Treatment
Population Rec #
Any RAS status and dMMR or MSI-H and patients not candidates for
intensive chemotherapy
2.8
RAS MUT 2.10
RAS MUT and patients with good PS and without major comorbidities, or
when tumor shrinkage is the goal
2.11
RAS MUT and preexisting neuropathy, elderly, comorbidities, or not
candidates for aggressive chemotherapy
2.12
Patients treated with oxaliplatin-based doublet or triplet chemotherapy ±
anti-VEGF therapy
2.13
b
Metachronous metastases, prior oxaliplatin-based chemotherapy for early-
stage disease (resectable) ≤12 (aka within) months of mCRC diagnosis
2.14
b
Prior oxaliplatin-based chemotherapy for early-stage disease (resectable)
≥12 months from diagnosis of mCRC
a
Qualifying Statement for First-Line immunotherapy: At the time of this writing, the US Food and
Drug Administration (FDA) had not approved the use of immune checkpoint inhibitors (e,g, single
agent pembrolizumab or nivolumab or the combination of nivolumab plus ipilimumab) in first-line
treatment of patients with mCRC.
b
See full text guideline.
Treatment
(cont'd)
