This protocol defines first-line systemic therapy for patients with metastatic colon adenocarcinoma confirmed as proficient mismatch repair (pMMR) / microsatellite stable (MSS), carrying a KRAS or NRAS mutation, with BRAF wild-type status. Molecular profiling is integral to identifying this subgroup and determining the appropriate treatment path.
Metastatic colon adenocarcinoma with confirmed pMMR/MSS status, a documented KRAS or NRAS mutation, and verified BRAF wild-type disease. This molecular profile — distinguishing it from MMR-deficient and BRAF-mutated tumours — directly shapes which first-line regimens apply.
Initial therapy involves combination chemotherapy-based regimens, with or without the addition of a targeted agent, selected based on patient performance status, treatment goals, and clinical context. The full protocol details the specific regimen options, selection criteria, and relevant considerations — see the structured protocol below.