{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T04:12:47Z","timestamp":1783743167426,"version":"3.55.0"},"reference-count":68,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Med Oncol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Metastatic colorectal cancer (mCRC) is a major public health burden in Taiwan. Despite multiple later-line therapies, outcomes remain suboptimal. International guidelines provide valuable direction, but are difficult to apply locally due to differences in drug accessibility, reimbursement policies, and practice patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This initiative developed a Taiwan-specific, consensus framework for managing mCRC in the third line and beyond.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This consensus integrated global evidence with local practice, real-world data, and reimbursement considerations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A multidisciplinary panel of 20 experts convened by the Taiwan Society of Colon and Rectal Surgeons (TSCRS) used a modified Delphi process. Initial recommendations were adapted from European Society for Medical Oncology (ESMO), Pan-Asian ESMO, and National Comprehensive Cancer Network (NCCN) guidelines, supplemented by Taiwan real-world data. Consensus was achieved through three structured rounds of voting and discussion, with final statements graded by level of evidence and strength of agreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twelve recommendations spanning three domains were endorsed: disease management, third-line options, and extended strategies. Key local adaptations include aligning imaging schedule intervals with Taiwan\u2019s National Health Insurance reimbursement policies and prioritizing trifluridine\/tipiracil and regorafenib as preferred third-line agents. The panel acknowledged emerging options such as fruquintinib, epidermal growth factor receptor antibody rechallenge, and novel chemotherapy combinations. While the panel strongly supported biomarker-informed treatments, their broader implementation is constrained by limited reimbursement coverage for next-generation sequencing. Other challenges included limited drug access, suboptimal uptake of biomarker testing, and reimbursement constraints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This Taiwan-specific consensus provides a practical, evidence-based framework for late-line mCRC treatment, bridging global standards with local realities to improve policy alignment and optimize patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17588359261457553","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:28:22Z","timestamp":1783574902000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing third-line and beyond therapies for metastatic colorectal cancer in Taiwan: an evidence-based 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