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CME: Metastatic colorectal cancer (mCRC) treatment: Therapeutic updates, best practices, and barriers to care


Activity Description / Statement of Need:

In this online CME self-learning program:

Colorectal cancer (CRC) is the third-leading cause of cancer deaths in the U.S. While a majority of patients are diagnosed before their disease has metastasized, a fifth of patients have advanced disease at the time of diagnosis. Early detection and screening have been shown to significantly reduce CRC mortality, and screening is widely recommended for average-risk adults beginning at age 50 years, (as well as earlier for individuals at higher risk). Since the mid-1990s, the U.S. Preventive Services Task Force, American Cancer Society, and other groups have recommended several modalities for screening: fecal occult blood testing (FOBT), flexible sigmoidoscopy, colonoscopy, and barium enema. Recent years have seen the addition of newer screening technologies, including stool DNA, computed tomographic colonography, and capsule endoscopy.

Target Audience:

Healthcare professionals including: medical oncologists, primary care physicians, pathologists, gastroenterologists, and managed care medical care directors; physicians assistants, nurse practitioners, nurses, and pharmacists specializing in oncology; and other clinicians who are involved in providing diagnostic and therapeutic services for patients with CRC.

This program is supported by educational grants from Merck.

Learners may participate in this activity free of charge.

Release Date: February 03, 2021 -- Expiration Date: February 03, 2023

Faculty: Kurt Melstrom, MD


Faculty introduction, disclosures

Introduction content: Cursory refresher and review

  • Epidemiology: Statistics by severity, current trends, and associated healthcare costs
  • Causes and risk factors
  • Pathogenesis, including biochemical pathways and their effects on the cell life cycle
  • Clinical features, presentation, histopathology, genetics, and biomarkers

Treatment of CRC

  • Developing patient-specific plans to treating mCRC
  • Initial approach

· Conventional chemotherapy ± epidermal growth factor receptor inhibition

  • Evolving role of biomarkers’ roles in guiding treatment
  • Present and emerging treatments, including targeted therapies, for mCRC progression beyond first-line therapy

· RAS wild-type, BRAF mutations

· Antiangiogenic therapy: tyrosine kinase, vascular endothelial growth factor inhibition

· Nucleoside analog plus thymidine phosphorylase inhibition

· Microsatellite unstable or mismatch repair deficiency

· HER2 overexpression

· TRK fusion positivity

  • Safety profiles of current and emerging agents and their management [Objectives #2 & 3]
  • Emerging models of care

· Putting it all together: integrated, best practice

· Patient case(s) [Objectives #2]

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Recall the role of biomarkers in shaping therapeutic decision-making.
  • Describe treatment options presently available for mCRC, including optimal treatment sequencing and adverse effect management, and apply them to patient cases, taking into account patient history and tumor characteristics.
  • List emerging treatment options for mCRC, their mechanisms of action, safety, and anticipated place in therapy.


ACCME Activity #201718487

ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians. 

Credit Designation: ScientiaCME designates this internet activity enduring material for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.


ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

PhysiciansFor maintenance of certification (MOC) credit, you must enter your board certification ID # and birth date correctly. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC credit for this activity. Please note: Not all activities on this site provide MOC credit. If this activity does not specify that it provides MOC credit in this section, then it does NOT provide MOC credit.


ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hours (0.1 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE # 0574-0000-21-003-H01-P. This is an Application (A)-type activity.

Pharmacists: You must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.  ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.

Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.

Faculty Disclosure: Kurt A. Melstrom, MD, FACS, FASCRS, Assistant Clinical Professor, City of Hope, has no relevant financial disclosures.

Disclosure of Peer Reviewer: Daniel I-Hsin Chu, MD, FACS, FASCRS, discloses that he has recieved compensation from federal government research grants.

Disclosure of Peer Reviewer: Farshid Dayyani, MD discloses that he has received compensation from research grants and/or consulting fees from Deciphera, Eisai, Excelis, Ipsen, QED,  Signatera, Sirtex, AZD, BMS, Taiho, Merck, Genentech, FIM, Amgen, and Array.

Disclosures of Educational Planners: Charles Turck, PharmD, CEO of ScientiaCME, has no relevant financial disclosures.

Commercial Support Disclosure: This program is supported by educational grants from Merck.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

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Ovarian Cancer: Therapeutic Updates, Best Practices, and Emerging Treatments