Consensus generation
for Metastatic CRC
Overview
Despite global consensus on treatments for metastatic colorectal cancer targeting different mutations like EGFR, VEGF, and HER2, the Indian context lacks clarity. The client, large sized Indian pharma, wanted to help establish the same in India which is capture in the case study below. Collaborating closely with Indian oncologists, we analyzed local data and practices, revealing insights crucial for optimizing therapies like Cetuximab and Bevacizumab. This effort led to the publication of the Indian Consensus in a peer-reviewed journal, bridging the gap and guiding tailored treatment approaches nationwide.
Introduction
Metastatic Colorectal Cancer (CRC) remains a significant challenge in oncology, with multiple therapeutic options targeting different pathways such as EGFR, VEGF, and HER2. While there is global clarity in therapy sequencing through American and European guidelines, the Indian context lacks a consensus. This case study by Atticus Healthcare highlights the strategic approach taken to generate a consensus on the sequencing of therapy for metastatic CRC in India.
Problem Statement
The primary issue was the absence of an Indian consensus on the sequencing of therapies for metastatic CRC. Despite the availability of multiple therapies targeting different pathways, there was a lack of clarity and uniformity in treatment protocols among Indian oncologists. The need was to establish a consensus that would guide oncologists in effectively managing metastatic CRC in the Indian population.
Approach and Methodology
Patient Demographics:
- Identified different patient profiles based on factors like age, sex, past medical history, site of the primary tumor, and the number of previous treatment lines.
Therapy Sequencing:
- Highlighted the sequencing of therapy with existing molecules such as Cetuximab and Bevacizumab based on patient profiles.
Engagement with Oncologists:
- Conducted multiple advisory board meetings with leading oncologists from across India.
Data Review:
- Undertook critical appraisal of past and present data of various molecules.
- Reviewed significant trials like FIRE-3 to understand the efficacy and outcomes of different therapies.
Insights from KOLs:
- Key Opinion Leaders (KOLs) shared contemporary practices from their private practices and clinical experiences.
Practice Sharing:
- Discussed real-world data and treatment outcomes to understand the practical applications of different therapies in the Indian context.
Outcomes and Results
Highlighting Therapy Sequencing
- Right-Sided Primary Tumors:
- Discussions revealed that patients with a primary tumor on the right side might benefit from initiating therapy with Bevacizumab, followed by Cetuximab after the failure of first-line therapy.
- Therapy Efficacy:
- The sequencing of therapies was tailored to optimize patient outcomes based on tumor location and other patient-specific factors.
Publication and Dissemination
- Indian Consensus Publication:
- The findings and recommendations were published as the Indian Consensus on Metastatic Colorectal Cancer in a peer-reviewed journal.
- CME Programs:
- The consensus was further disseminated through Continuing Medical Education (CME) programs to oncologists across India, ensuring widespread adoption and implementation.
Conclusion
The development of an Indian-specific consensus on the sequencing of therapies for metastatic CRC represents a significant step forward in personalized cancer care. By leveraging expert insights, real-world data, and rigorous analysis, Atticus Healthcare facilitated a collaborative approach to address a critical gap in the Indian oncology landscape. This case study underscores the importance of local context in developing treatment guidelines and highlights the value of consensus-building initiatives in improving patient outcomes.
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