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Colorectal Cancer — SCE Medical Oncology MCQ

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HardGI CancersColorectal CancerSCE Medical Oncology

A patient with metastatic colorectal cancer remains ECOG 1 after fluoropyrimidine-, oxaliplatin- and irinotecan-based therapy plus anti-VEGF treatment. The tumour is MSS, RAS-mutant and has no actionable alteration. Which current NICE option is specifically recommended after two systemic treatment lines?

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Correct answer: B — Trifluridine-tipiracil with bevacizumab, subject to the commercial arrangement

TA1008 recommends trifluridine-tipiracil with bevacizumab after two treatment lines containing the specified chemotherapy and relevant targeted agents. The combination improved progression-free and overall survival over trifluridine-tipiracil alone. Pembrolizumab is not selected for MSS disease, anti-EGFR treatment is inappropriate in RAS-mutant cancer, and NG151 positions fruquintinib when the TA1008 combination is unsuitable.

Reference: NICE TA1008 trifluridine-tipiracil with bevacizumab after 2 systemic treatments (Published September 2024): https://www.nice.org.uk/guidance/ta1008/chapter/1-Recommendation; NICE NG151 colorectal cancer recommendations (Updated with 2025–2026 technology appraisals): https://www.nice.org.uk/guidance/ng151/chapter/Recommendations