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CC BY-NC-ND 4.0 · South Asian J Cancer
DOI: 10.1055/s-0045-1809380
Consensus

Consensus Statements for Clinical Practice in Advanced/Metastatic Colorectal Cancers in India Using a Modified Delphi Method

Anant Ramaswamy
1   Department of Medical Oncology, Tata Memorial Hospital (Homi Bhabha National Institute), Mumbai, Maharashtra India
,
Sujay Srinivas
2   Department of Medical Oncology, Bharath Hospital, Kottayam, Kerala, India
,
Viraj Lavingia 
3   Department of Medical Oncology, Shalby Hospital, Ahmedabad, Gujarat, India
,
Mounika Boppana
4   Department of Medical Oncology and Haematoncology, Krishna Institute of Medical Sciences (KIMS) Hospital, Secunderabad, Hyderabad, Telangana, India
,
Chakor Vora
5   Department of Medical Oncology, Sassoon General Hospital, Pune, India
,
Randeep Singh
6   Department of Medical and Hemato-Oncology, Narayana Health, Gurugram, Haryana, India
,
M. Vamshi Krishna
7   Department of Medical Oncology and Haematology, Institute of Oncology AIG Hospitals, Hyderabad, Telangana, India
,
Amish Vora
8   Department of Medical Oncology, H.O.P.E. Oncology Clinic, New Delhi, India
,
Sujith Kumar Mullapally 
9   Department of Medical Oncology, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
,
Prabhat Bhargava 
1   Department of Medical Oncology, Tata Memorial Hospital (Homi Bhabha National Institute), Mumbai, Maharashtra India
,
Vinayak Maka
10   Department of Medical Oncology, Ramaiah Medical College, Bengaluru, Karnataka, India
,
Gautam Goyal
11   Department of Medical Oncology and Hemato-Oncology, Max Super Specialty Hospital, Mohali, India
,
Vivek Agarwala 
12   Department of Medical Oncology and Hemato-Oncology, Narayana Health, Kolkata, Bengal, India
,
Ashay Karpe
13   Department of Medical Oncology, Sunrise Oncology Centre, Mumbai, Maharashtra, India
,
Jimmy Mirani
14   Department of Medical Oncology, Wockhardt Hospital, Mumbai Central, Maharashtra, India
,
S Krupa Shankar
15   Department of Medical Oncology, NSR CanKure Center, Coimbatore, Tamil Nadu, India
,
Tanmoy Kumar Mandal
16   Department of Medical Oncology, AMRI Hospital, Dhakuria, Kolkata, West Bengal, India
,
Sourav Kumar Mishra
17   Department of Medical Oncology/Hematology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Nisar Ahmad Syed
18   Department of Medical Oncology, Sheri Kashmir Institute of Medical Sciences SKIMS, Soura, Jammu and Kashmir, India
,
Atul Sharma
19   Department of Medical Oncology and Hemato-Oncology, Max Super Specialty Hospital, Saket, New Delhi, India
,
Shasanka Sekhar Das
20   Department of Medical Oncology, HCG EKO Cancer Center, Kolkata, West Bengal, India
,
Soumya Surath Panda 
21   Department of Medical Oncology, IMS & SUM Hospital, Bhubaneswar, Odisha, India
,
Pradip Kumar Mondal
22   Department of Medical Oncology, Medica Super Specialty Hospital Mukundapur, Kolkata, West Bengal, India
,
Amit Kumar
23   Department of Medical Oncology and Hemato-Oncology, Jay Prabha Medanta Super Specialty Hospital, Patna, Bihar, India
,
Shekar Patil
24   Department of Medical Oncology, HCG Hospital Bangalore, Karnataka, India
,
Rakesh Pinninti
25   Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, Telangana, India
,
Ajoy Oommen John
26   Department of Medical Oncology, CMC Vellore, Ranipet Campus, Vellore, Tamil Nadu, India
,
Murtaza Bohra
27   Department of Medical Oncology, National Cancer Institute, Nagpur, India
,
Rejiv Rajendranath
28   Department of Medical Oncology, Integrated Cancer Care Group, GEM Hospital, Institute of Gastroenterology and Laparoscopy, Chennai, Tamil Nadu, India
,
Sudeep Das
29   Department of Medical and Hemato-Oncology, Medica Superspecialty Hospital, Mukundapur, Kolkata, West Bengal, India
,
Sumit Goyal
30   Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, Delhi, India
,
Rakesh M. P.
31   Department of Medical Oncology, Amrita Institute of Medical Sciences, Kerala, India
,
Krishnakumar Rathnam
32   Department of Medical Oncology, Meenakshi Mission Hospital, Chinthamani Madurai, Tamil Nadu, India
,
Amol Patel 
33   Department of Medical Oncology, Command Hospital, Central Command, Lucknow, Uttar Pradesh, India
,
Boman Dhabhar
34   Department of Medical Oncology, Fortis Hospital Mulund, Mumbai, Maharashtra, India
,
Aditi Thanky
35   Department of Medical Oncology, Sterling Hospital, Rajkot, Gujarat, India
,
Vipul Doshi
36   Department of Medical Oncology, Solapur Cancer Centre, Solapur, India
,
Akhil Kapoor 
37   Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Homi Bhabha National Institute, Varanasi
,
Nishitha Shetty
38   Department of Medical Oncology, Father Muller Medical College, Mangalore, Karnataka, India
,
Davinder Paul
39   Department of Medical Oncology, Fortis Hospital, Ludhiana, Punjab, India
,
Jacob George
40   Department of Medical Oncology, Manipal Hospital, Panaji, Goa, India
,
Akshay D. Baheti
41   Department of Radiodiagnosis, Tata Memorial Hospital (Homi Bhabha National Institute), Mumbai, Maharashtra India
,
Rahul Krishnatry 
42   Department of Radiation Oncology, Tata Memorial Hospital (Homi Bhabha National Institute), Mumbai, Maharashtra India
,
Vikas Ostwal 
1   Department of Medical Oncology, Tata Memorial Hospital (Homi Bhabha National Institute), Mumbai, Maharashtra India
› Author Affiliations
Funding None.
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Abstract

Background

Colorectal cancer (CRC) is one of the most common malignancies across the world and is the fourth most common cancer among men in India as per the Global Cancer Observatory (GLOBOCAN) data 2020. Available data suggest that approximately 30% of patients present with advanced/metastatic CRC (mCRC). This publication summarizes the latest evidence with cognizance of the unique challenges faced in India by medical oncologists treating mCRC.

Methods

A panel of 38 medical oncologists held a meeting in February 2023 and reviewed the evidence available for the management of mCRC. The meeting concentrated on the recognition and management of mCRC with a focus on systemic therapeutic approaches. A literature review of these aspects of management leads to the formation of consensus statements with the level of evidence and grades of recommendation. Statements were evaluated by the modified Delphi method.

Key Content and Findings

The panel comprising 38 experts formulated 51 consensus statements with regard to the management of mCRC, including oligometastatic CRC, unresectable CRC, as well as various systemic therapeutic options. Resource-constrained scenarios, specifically with regard to the economic constraints and availability of drugs in India, were evaluated as part of the statements.

Conclusion

Our consensus statements offer practical, yet evidence-based management guidelines for treating mCRC in the Indian context. Stratifying and recommending treatment options in a resource-constrained scenario is an important aspect of these statements.

Keywords

India specific - metastatic colorectal cancer - modified Delphi consensus

Authors’ Contributions

All authors contributed equally and approved the manuscript.




Publication History

Received: 28 September 2024

Accepted: 02 May 2025

Article published online:
26 May 2025

© 2025. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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