Using Targeted Treatment Options for the Management of BRAF-mutant Metastatic Colorectal Cancer: How Does Your Approach Compare With the Experts?

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A 72-year-old man undergoes CT imaging for severe abdominal pain which shows an obstructing transverse colonic mass and two liver lesions. He undergoes surgery to divert the colon, and work-up of liver biopsy is positive for metastatic colon cancer. At which point should you consider sending a sample of the primary tumor for molecular testing?
A 60-year-old woman presents to the emergency department with abdominal bloating and distention that have significantly worsened over the past week. She tells you that she has experienced right upper quadrant pain and feels full even though she hasn’t been finishing her meals. Work-up shows MSI-high, BRAF V600 positive, mCRC. Which of the following do you recommend?
A 56-year-old man with a history of mild inflammatory bowel disease and previous hemicolectomy for microsatellite stable and T3NO poorly differentiated colon cancer. He presents for one-year follow-up, and PET scan shows unresectable asymptomatic metastasis in lung and liver. He is treated with a combination regimen that includes bevacizumab, but 8-month scan shows disease progression. Which of the following do you recommend?
Your patient is being treated in the second-line setting for BRAF V600E-mutant mCRC with a combination of cetuximab and encorafenib. You counsel your patient on the most frequently reported side effects of this combination. You also talk about the most serious side effects of cetuximab, which include which of the following?
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