Consideration of Metastasis-Directed Therapy for Patients With Metastatic Colorectal Cancer: Expert Survey and Systematic Review

Miller, Eric D, Klamer, Brett G, Cloyd, Jordan M, Pawlik, Timothy M, Williams, Terence M, Hitchcock, Kathryn E, Romesser, Paul B, Mamon, Harvey J, Ng, Kimmie, Gholami, Sepideh, Chang, George J, Anker, Christopher J (January 2024) Consideration of Metastasis-Directed Therapy for Patients With Metastatic Colorectal Cancer: Expert Survey and Systematic Review. Clinical Colorectal Cancer. S1533-0028(24)00004. ISSN 1533-0028

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Abstract

BACKGROUND: A survey of medical oncologists (MOs), radiation oncologists (ROs), and surgical oncologists (SOs) who are experts in the management of patients with metastatic colorectal cancer (mCRC) was conducted to identify factors used to consider metastasis-directed therapy (MDT). MATERIALS AND METHODS: An online survey to assess clinical factors when weighing MDT in patients with mCRC was developed based on systematic review of the literature and integrated with clinical vignettes. Supporting evidence from the systematic review was included to aid in answering questions. RESULTS: Among 75 experts on mCRC invited, 47 (response rate 62.7%) chose to participate including 16 MOs, 16 ROs, and 15 SOs. Most experts would not consider MDT in patients with 3 lesions in both the liver and lung regardless of distribution or timing of metastatic disease diagnosis (6 vs. 36 months after definitive treatment). Similarly, for patients with retroperitoneal lymph node and lung and liver involvement, most experts would not offer MDT regardless of timing of metastatic disease diagnosis. In general, SOs were willing to consider MDT in patients with more advanced disease, ROs were more willing to offer treatment regardless of metastatic site location, and MOs were the least likely to consider MDT. CONCLUSIONS: Among experts caring for patients with mCRC, significant variation was noted among MOs, ROs, and SOs in the distribution and volume of metastatic disease for which MDT would be considered. This variability highlights differing opinions on management of these patients and underscores the need for well-designed prospective randomized trials to characterize the risks and potential benefits of MDT.

Item Type:	Paper
Subjects:	diseases & disorders > cancer diseases & disorders diseases & disorders > cancer > cancer types > colon cancer diseases & disorders > cancer > cancer types > colon cancer diseases & disorders > cancer > metastasis diseases & disorders > cancer > cancer types
CSHL Authors:	Gholami, Sepideh
SWORD Depositor:	CSHL Elements
Depositing User:	CSHL Elements
Date:	30 January 2024
Date Deposited:	11 Apr 2024 18:30
Last Modified:	11 Apr 2024 18:30
Related URLs:	Publisher
URI:	https://repository.cshl.edu/id/eprint/41510

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