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HER2+ + RAS WT
Intermediate PrognosisGenes Involved
HER2
RAS Wild-type
Treatment Implications
Tucatinib + Trastuzumab (MOUNTAINEER, ORR 38%, OS 24.1mo, FDA approved Jan 2023). Trastuzumab Deruxtecan 5.4mg/kg (DESTINY-CRC02). Trastuzumab + Pertuzumab. Consider Zanidatamab combinations in trials.
Recommended Treatments
Tucatinib + Trastuzumab
Trastuzumab Deruxtecan 5.4 mg/kg
Trastuzumab + Pertuzumab
Treatments to Avoid
No specific contraindications noted
Study References
MOUNTAINEER (PMID: 37142372), DESTINY-CRC02
Key Statistics
3.00%
Prevalence in CRC
Yes
Targetable
Clinical Notes
Updated 2024: Multiple anti-HER2 options now available. Consider chemotherapy first-line, then anti-HER2 at progression. MOUNTAINEER-03 may change to first-line anti-HER2. CNS metastases: tucatinib has brain penetration.
Information
Category: General
Evidence Level: B
Last Updated: Dec 21, 2025
Medical Disclaimer: This information is for educational purposes only and should not replace professional medical advice. Always consult with your oncologist for personalized treatment decisions based on your specific situation.