Colorectal cancer (CRC) represents the third-leading cause of cancer death in both men and women in the United States, with an estimated 49,190 deaths in 2016.1 The treatment landscape for metastatic CRC (mCRC) is becoming more molecularly driven. The addition of epidermal growth factor receptor (EGFR)–targeting agents to conventional cytotoxic therapy based on RAS and BRAF mutation status in mCRC serves as a recent example of selecting optimal therapy according to patient genomic profiles and molecular phenotypes.2 This report presents a case in which the programmed cell death 1 (PD-1) receptor inhibitor pembrolizumab was offered based on comprehensive genomic profiling, which identified a polymerase ε (POLE) mutation associated with an ultramutated tumor in a patient with KRAS-mutated, microsatellite stable (MSS) metastatic colon adenocarcinoma.
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. Overman MJ Kopetz S McDermott RS Nivolumab ± ipilimumab in treatment (tx) of patients (pts) with metastatic colorectal cancer (mCRC) with and without high microsatellite instability (MSI-H): CheckMate-142 interim results [abstract]. J Clin Oncol 2016; 34( Suppl): Abstract 3501.
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