Exploring Current Metastatic Colorectal Cancer (mCRC) Treatment Options
Faculty: John Marshall, MD and Cathy Eng, MD

CME Accreditation for this article expired on May 31, 2019.

Exploring Current Metastatic Colorectal Cancer (mCRC) Treatment Options

  • CME: 1.5 AMA PRA Category 1 Credit(s)TM
  • CNE: 1.3 Contact hour
  • CPE: 1.5 Contact hour

Release Date: May 31, 2018
CME Accreditation for this article expired on May 31, 2019

Program Description:

The single-session, web-based CME activity will provide learners with current evidence-based best practice guidelines and medical knowledge in the treatment of metastatic colorectal cancer. Participants will also learn strategies to manage patient communication and ways to work effectively within an interprofessional team to improve outcomes.

Estimated time to complete this activity is one hour and thirty minutes.

Hardware And Software Requirements:

MedInsightsCE.com requires modern web browsers (recent version of Google Chrome or Mozilla Firefox, Safari 3 or higher, Microsoft Edge, Internet Explorer 11) and operating systems with DirectX 9 or higher such as Windows 7 or higher, Mac OS X 10.4 or higher. The minimum hardware requirements are 64-bit CPU (Intel or AMD) with minimum 128MB Internal V-RAM and 2GB DDR2 RAM. Some of the content may require additional plugins or software, in which case, there are particular packages to view the content. This software includes Adobe Flash, Apple Quicktime Media Player, Adobe Acrobat, Windows Media Player, VLC Media Player and RealOne player.

Target Audience:

This activity is intended for Oncology physicians, nurse practitioners, physician assistants, pharmacists, and nurses who are responsible for treatment of patients with metastatic colorectal cancer (mCRC).

Educational Objectives

After completing this activity, the participant should be better able to:

  • List NCCN treatment guidelines for first, second and third line therapies for mCRC patients.
  • Describe the risks associated with an ageist approach to care of geriatric patients with mCRC and how to avoid this approach.
  • Explain how RAS, BRAF and MSI testing plays a part in developing the most appropriate treatment plans.
  • Discuss primary and acquired treatment resistance and current evidence based treatment options for resistant mCRC.
  • Outline strategies to improve communication and education for patients with mCRC.
  • Identify jargon which may be confusing to patients and the importance of clear communication with patients about their treatment goals and prognosis.


John Marshall, MD

  • Chief, Division of Hematology/Oncology, Medstar Georgetown University Hospital
  • Professor of Medicine and Oncology, Lombardi Comprehensive Cancer Center, Georgetown University
  • Director, Otto J. Ruesch Center for the Cure of Gastrointestinal Cancer

Cathy Eng, MD

  • Professor, Department of Gastrointestinal (GI) Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX

Jointly provided by Postgraduate Institute for Medicine and MedInsights CE Academy.

This activity is supported by an independent educational grant from Taiho Oncology, Inc.


Accreditation Information


In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and MedInsights CE Academy. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


The Postgraduate Institute for Medicine designates this enduring material activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


The maximum number of hours awarded for this Continuing Nursing Education activity is 1.3 contact hour(s).


Postgraduate Institute for Medicine designates this continuing education activity for 1.5 contact hour(s) (0.01 CEUs) of the Accreditation Council for Pharmacy Education. Activity Type: Knowledge, UAN: JA4008162-9999-18-157-H04-P


American Association of Nurse Practitioners (AANP) National Certification Program accepts AMA PRA Category 1 CreditTM from organizations accredited by the ACCME.

American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 CreditTM from organizations accredited by the ACCME. Physician Assistants may receive a maximum of 1.0 credit of Category 1 for completing this program.


For any questions relating to certification for this activity, please contact Postgraduate Institute for Medicine at: inquiries@pimed.com or (303) 799-1930.

Program Agenda


  • mCRC Overview, Definitions, Prevalence and Effect on Patients (3 minutes)
  • Testing to Develop Individual Treatment Plans / Personalized Medicine (5 minutes)
    • Genotyping Patients for RAS (KRAS, NRAS) and BRAF at Diagnosis of Stage IV Disease
    • Microsatellite Instability (MSI)
    • Older Patients and Other Special Populations
  • Current NCCN Guidelines for First, Second and Third Line Therapy (30 minutes)
    • Metastasis at Diagnosis or Recurrence
    • Surgical and Nonsurgical Options with Primary, Adjuvant and Neoadjuvant Treatments
    • Chemotherapy, Targeted Therapy, and Other Treatment Options
    • Oxaliplatin, irinotecan, FOLFOXIRI, 5-FU/LV, capecitabine, FOLFOX, CAPEOX, bevacizumab, cetuximab, panitumumab, FOLFIRI, ziv-aflibercept, ramucirumab, pembrolizumab, nivolumab, regorafenib, trifluridine + tipiracil, etc.
    • Primary and Acquired Treatment Resistance
    • Side Effects
    • Clinical Trials and Best Supportive Care
    • Follow-Up Survivorship Care
  • Provider-Patient Communication Strategies (10 minutes)
    • Patient education, discussing expectations/prognosis and treatment plans
    • Methods and recommendations (National Cancer Institute and ASCO) for discussing bad news (including SPIKES and patient-centered approach)
    • Use of collaborative teams including nurse advocates
    • Additional Resources / Tools
  • Case Studies (7 minutes)
  • Questions and Answers (5 minutes)

How to Receive Credit

A statement of credit will be issued upon successfully completing the post-test with a score of 75% or better and the activity evaluation. The post-test is located on www.cmeuniversity.com.

During the period May 31, 2018 through May 31, 2019, participants must
1) read the learning objectives and faculty disclosures;
2) study the educational activity; and
3) complete the post-test and the evaluation form.

To answer the questions, click on your selected choice for each answer then proceed to the next question. We recommend that you print a copy of your answers before you submit them to us. Once completed, click on Submit Post-test at the bottom of the page. Your post-test will automatically be graded.

If you successfully complete the post-test (score of 75% or higher), your certificate will be made available immediately. Click on View Certificate and print the certificate for your records. If you receive a score of 74% or less, you will receive a message notifying you that you did not pass the post-test. You may retake the post-test until successful.

There is no fee for this educational activity.



Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.


John Marshall, MD

  • Consulting Fees & Fees for Non-CME/CE Services Received Directly from a Commercial Interest: Genentech, Amgen, Bayer, Celgene, Caris, Taiho.

Cathy Eng, MD

  • Consulting Fees: Genentech, Bayer.
  • Contracted Research: Roche, Forty-Seven, Inc.


The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose. The MedInsights planners and managers, Kristen Holstead and Laurette Ullian, have nothing to disclose.


This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

Media: Internet


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