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Cancers & treatments·Sequencing

HER2-amplified colorectal cancer: lines of therapy

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3 standard-of-care settings across 2 lines and 3 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineEGFRHER2RAS
Advanced, first line1·1
Other settings·1·

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
EGFRMetastatic, first lineStandard doublet chemotherapy with bevacizumab; anti-EGFR antibodies are less effective in HER2-amplified tumours; tucatinib-trastuzumab-FOLFOX is under test in MOUNTAINEER-03.
FOLFOX (5-FU, leucovorin, oxaliplatin)FOLFIRI (5-FU, leucovorin, irinotecan)BevacizumabA Study of Tucatinib With Trastuzumab and mFOLFOX6 Versus Standard of Care Treatment in First-line HER2+ Metastatic Colorectal Cancer
98
RASMetastatic, RAS wild-type, previously treatedTucatinib plus trastuzumab (MOUNTAINEER); trastuzumab plus pertuzumab or lapatinib where tucatinib is unavailable.
MOUNTAINEER & MOUNTAINEER-03TucatinibTrastuzumabPertuzumabHER2 tyrosine kinase inhibitors
92

Other settings

SubgroupSettingApproachProducts and trialsEvidence
HER2After HER2 antibodies, or with RAS mutationTrastuzumab deruxtecan (DESTINY-CRC02; tumour-agnostic approval for immunohistochemistry 3+), watching for pneumonitis.
DESTINY-CRC02Trastuzumab deruxtecanAntibody-drug conjugate (ADC)
98

Sequence and caution pairings

CautionApproved
Caution: DXd ADC + agents with pneumonitis risk

Enhertu and its DXd cousins can inflame the lungs; combining them with immunotherapy, radiation, or mTOR inhibitors stacks that risk.

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.