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Targeted and immunotherapies for colorectal cancer

This section covers the following topics:

Immunotherapies 

Immunotherapies help the body’s immune system detect and attack cancer cells.

  • Immune checkpoint inhibitors are often used to treat advanced or colorectal cancer that have MSI-H or dMMR; usually after other treatments have been tried. The most common immune checkpoint inhibitors used for colorectal cancer are:
    • Jemperli (dostarlimab)
    • Keytruda (pembrolizumab)
    • Opdivo (nivolumab)
    • Yervoy (ipilimumab)

Targeted therapies

Tageted therapies are designed to attack or kill cancer cells, while sparing normal cells as much as possible. These therapies are often designed to target abnormal proteins, receptors or genes that are found in high quantities in cancer cells or the surrounding tissue. Several targeted therapies are used to treat advanced or colorectal cancer.  Some work best for people with or without a certain

  • Anti VEGF therapies block tumors from forming blood vessels. Anti VEGF drugs used to treat colorectal cancer include:
    • Avastin (bevacizumab) 
    • Cyramza (ramucirumab)
    • Fruzaqla (fruquintinib)
    • Zaltrap (ziv-aflibercept)
  • Anti EGFR therapies slow down tumor cell growth. Anti EGFR drugs used to treat colorectal cancer include:
    • Erbitux (cetuximab)
    • Vectibix (panitumumab)
  • BRAF inhibitors are oral medications that help slow down tumor growth in advanced colorectal cancers that test positive for the tumor called a BRAF V600E mutation. BRAF inhibitors are usually given in combination with other oral targeted drugs called MEK inhibitors (e.g., trametinib [Mekinist] or binimetinib [Mektovi]). BRAF inhibitors include:
    • Tafinlar (dabrafenib)
    • Braftovi (encorafenib)
  • Stivarga (regorafenib) blocks several different types of proteins in the body that tumors use to grow. Stivarga may be used to treat  colorectal cancer that has come back after treatment with other drugs. 
  • Herceptin (trastuzumab) and Tukysa (tucatinib) are used in combination for people with advanced colorectal cancer when tumor testing shows a  called
  • Vitrakvi (larotrectinib) is approved for treatment of advanced cancers that have worsened with other treatments. It targets a genetic change called an NTRK fusion. This type of genetic change is found in a range of cancers, including some colon cancers.

Table of targeted and immunotherapies for colorectal cancer

Name of drug Type of agent Cancer Indication
Herceptin (trastuzumab) and Tukysa (tucatinib) combination  or unresectable colorectal cancer For people who progressed after chemotherapy and RAS wild-type
Jemperli (dostarlimab) Immune checkpoint inhibitor  or  unresectable colorectal cancer For people who progressed after chemotherapy High (MSI-H) or  ()
Keytruda (pembrolizumab) Immune checkpoint inhibitor or  unresectable colorectal cancer For treatment of or unresectable colorectal cancer High (MSI-H) or  (
or  unresectable For treatment of that have progressed after treatment and for which there are no other treatment options High (MSI-H) or  (
or  unresectable For the treatment of that have progressed after treatment and for which there are no other treatment options High (TMB-H)
or unresectable colorectal cancer Cancer that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan High (MSI-H) or  (
Opdivo 
(nivolumab)
Immune checkpoint inhibitor colorectal cancer

As a single agent or in combination with Yervoy (ipilimumab) for cancer that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan

High (MSI-H) or  (
Yervoy (ipilumumab) Immune checkpoint inhibitor colorectal cancer Combined with Opdivo (nivolumab) for cancer that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan High (MSI-H) or  (
Avastin
(bevacizumab)
Targets vascular endothelial growth factor (VEGF) colorectal cancer Combined with intravenous 5-fluorouracil-based chemotherapy for first- or second-line treatment No required
colorectal cancer In combination with chemotherapy for second-line treatment in patients who have progressed on a Avastin-containing regimen No required
Cyramza
(ramucirumab)
Targets vascular endothelial growth factor (VEGF) colorectal cancer Combined with FOLFIRI chemotherapy, for treatment after disease progression on, or after prior therapy with bevacizumab, oxaliplatin, and a fluoropyrimidine No required
Erbitux
(cetuximab)
Targets  epidermal growth factor receptor (EGFR) colorectal cancer Combined with FOLFIRI for treatment, or combined with irinotecan for cancers that no longer respond to irinotecan-based chemotherapy or as a single agent in patients who have progressed after oxaliplatin- and irinotecan-based chemotherapy EGFR positive and KRAS mutation negative
Fruzaqla
(fruquintinib)
Targets vascular endothelial growth factor (VEGF) colorectal cancer As a single agent for patients who have progressed after treatment with chemotherapy and No required
Vectibix
(panitumumab)
Targets  epidermal growth factor receptor (EGFR) colorectal cancer Combined with FOLFOX for treatment Negative for KRAS and NRAS tumor mutations
colorectal cancer As a single therapy following disease progression after prior treatment with fluoropyrimidine, oxaliplatin, and irinotecan-containing chemotherapy Negative for KRAS and NRAS tumor mutations

 

Last updated November 12, 2023

Paying For Care
Paying For Care

Paying for cancer treatment

The majority of public and private health insurance plans are required to cover cancer diagnosis and treatment; copays, coinsurance and deductibles often apply. Patient costs and coverage for specific doctors, facilities or treatments may vary based on your health plan. Visit our section on Insurance and Paying for Care: Treatment  for more information, links to sample appeal letters and other resources. 

If you need information about finding an insurance plan, watch our video: Choosing Wisely: How to Pick Insurance Plans.

Some pharmaceutical companies have assistance programs that help cover the cost for their medications: 

Organizations that offer co-pay assistance:

Other resources:

  • The American Cancer Society provides information and resources on covering the cost of cancer care. Public assistance, such as Medicaid may be available if you are ineligible for other programs. 
  • Needy Meds: Assistance programs to help patients with cost of medications and other healthcare.
  • Triage Cancer offers tools and resources to help individuals cope with the financial aspects of a cancer diagnosis.

updated: 02/10/2023

Open Clinical Trials
Open Clinical Trials

The following are studies enrolling people with advanced colorectal cancer.  

A number of other clinical trials for patients with colorectal cancer can be found here.

updated: 11/12/2023