Considering the 76 metastatic patients, 50 (66%) underwent first-line therapy for metastatic disease with chemotherapy (doublet or triplet) +/− targeted therapy (anti-vascular endothelial growth factor [VEGF] or anti-epidermal growth factor receptor [EGFR] antibody), 18 patients (24%) received a second-line therapy (doublet or mono-chemotherapy +/− targeted therapy) and only 10 patients (13%) received a third line therapy (regorafenib or TAS 102). The gene discussed is VEGFA; the disease is metastatic neoplasm.