Colorectal Cancer Medicines in India: Imported Options by Gene Result

Written by Nitin Goswami Medically reviewed by Dr. Chirag C Shah Last updated 13 November 2026

QUICK ANSWERColorectal cancer, also called bowel cancer, covers cancer of the colon and the rectum. It was the fourth most common cancer in India in 2024, with an estimated 83,577 new cases [1]. Indian hospital studies show that patients here are often younger than in Western countries and that the rectum is involved more often than the colon [3, 4]. Once the cancer has spread, the choice of medicine depends heavily on the tumour's gene report: BRAF, KRAS, MSI or mismatch repair, HER2 and NTRK. Several newer medicines for these groups carry US FDA or Chinese NMPA approval yet are not stocked in Indian pharmacies. Through Named Patient Program (NPP), 11 of them can be imported for an individual patient on an oncologist's prescription.

83,577

new colorectal cancer cases in India in 2024 – 5.3% of all new cancers, the 4th most common

Source: IARC GLOBOCAN 2024 [1]

3rd

most common cancer in Indian men in 2024, with 48,536 new cases (6.2% of cancers in men)

Source: IARC GLOBOCAN 2024 [1]

34.7%

of 970 colorectal cancer patients treated at AIIMS New Delhi were aged 40 or younger (337 patients)

Source: AIIMS study, 2000–2019 [3]

58.7%

of the same 970 AIIMS patients had cancer of the rectum (569), and 41.3% of the colon (401)

Source: AIIMS study, 2000–2019 [3]

What Indian hospital data say about bowel cancer

Bowel cancer is often described as a disease of people over 50. Several Indian cancer centres have reported a different picture, with many patients in their 20s, 30s and 40s:

AIIMS, New Delhi: among 970 patients treated over two decades, the average age at diagnosis was 47.7 years, and most patients came with stage II or III disease [3]. Of the rectal cancers, 58% were in the lower rectum, close to the anus.
IGIMS, Patna: 344 of 1,028 patients (33.4%) were younger than 40. In this younger group, 74.1% had rectal cancer [4].
Kidwai Memorial Institute, Bengaluru: 279 of 964 patients (28.8%) were under 45. These younger patients more often had signet ring, mucinous or poorly differentiated tumours, and were more likely to have spread at diagnosis [5].
AIIMS, New Delhi (metastatic disease): in 377 patients with cancer that had spread, the median age was 46 and the rectum was the most common starting point. Only 12.5% received a biological medicine with their first chemotherapy [6].

GLOBOCAN estimates 38,499 deaths from colorectal cancer in India in 2024 [1]. Worldwide, it is the third most common cancer, with about 2,041,007 new cases in the same year [2].

The gene report decides which newer medicine fits

For bowel cancer that has spread, treatment usually begins with chemotherapy; at AIIMS, 70% of such patients first received an oxaliplatin-based combination [6]. The medicines on this page are used alongside it or after it, and most are linked to a specific result on the tumour test. Indian studies show these results vary from one centre and testing method to another:

Tumour test result	What Indian studies found	Medicines on this page
BRAF V600E	3 of 330 patients (1%) at Tata Memorial Hospital, Mumbai [7]; 7.1% of 112 tumours in a sequencing study [8]	Braftovi (with cetuximab, with or without fluorouracil-based chemotherapy)
KRAS mutation	15.4% at Tata Memorial, where G12D was the most frequent type [7]; 35.7% of 112 tumours tested by next-generation sequencing in another Indian cohort [8]	Lumakras with panitumumab, only for the G12C type
MSI-high or mismatch repair deficient (dMMR)	Indian data are limited; a 17-centre study of bowel and other cancers found MSI-high or MMR-deficient tumours in 129 of 519 patients, and an inherited Lynch syndrome change in 66 of those 129 [9]	Opdivo (alone or with ipilimumab), Jemperli
HER2-positive	No large Indian figure found	Trastuzumab Rezetecan (China NMPA)
NTRK gene fusion	Rare; no Indian figure found	Vitrakvi, Rozlytrek, Augtyro (approved for any solid tumour with this fusion)
Any result, after standard chemotherapy	–	Fruzaqla or Elunate (fruquintinib), Zaltrap with FOLFIRI

The two BRAF figures and the two KRAS figures come from different hospitals and different methods: Sanger sequencing at Tata Memorial [7] and next-generation sequencing in the other cohort [8]. Ask your lab which test was used on your sample.

Imported colorectal cancer medicines by type

All 11 medicines below are prescription-only. Tap a type to filter. Each card opens the full medicine page with dosage, storage and safety details.

Braftovi

encorafenib · Capsule

Metastatic BRAF V600E colorectal cancer in adults, with cetuximab and fluorouracil-based chemotherapy, or with cetuximab after earlier therapy

BRAF V600E US FDA

Lumakras

sotorasib · Tablet

Combined with panitumumab for KRAS G12C bowel cancer that has spread, once fluoropyrimidine, oxaliplatin and irinotecan have been used

KRAS G12C US FDA

Opdivo

nivolumab · IV infusion

MSI-H/dMMR colorectal cancer that cannot be removed or has spread, with ipilimumab; alone after fluoropyrimidine, oxaliplatin and irinotecan (age 12+)

MSI-H/dMMR US FDA

Jemperli

dostarlimab · IV infusion

Stage II/III MSI-H/dMMR locally advanced rectal cancer (accelerated approval); also dMMR advanced solid tumours after earlier treatment

MSI-H/dMMR US FDA

Trastuzumab Rezetecan

trastuzumab rezetecan · IV infusion

HER2-positive colorectal cancer after standard bowel cancer chemotherapy (approved August 2026)

HER2-positive China NMPA

Vitrakvi

larotrectinib · Capsule

Solid tumours with an NTRK gene fusion, including bowel cancer, that have spread or are unsafe to remove and have no satisfactory alternative

NTRK fusion US FDA

Rozlytrek

entrectinib · Capsule

NTRK fusion-positive solid tumours that have spread or are unsafe to remove, after other treatment or with no satisfactory option (accelerated approval)

NTRK fusion US FDA

Augtyro

repotrectinib · Capsule

NTRK fusion-positive solid tumours, locally advanced or metastatic, age 12+, after other treatment or with no satisfactory option (accelerated approval)

NTRK fusion US FDA

Fruzaqla

fruquintinib · Capsule

Spread bowel cancer already treated with fluoropyrimidine, oxaliplatin and irinotecan, an anti-VEGF medicine and, for RAS wild-type tumours where suitable, an anti-EGFR medicine

After chemotherapy US FDA

Elunate

fruquintinib · Capsule

Chinese brand of fruquintinib for metastatic colorectal cancer already treated with fluoropyrimidine, oxaliplatin and irinotecan (approved 2018)

After chemotherapy China NMPA

Zaltrap

ziv-aflibercept · IV infusion

With FOLFIRI for metastatic colorectal cancer that resisted or progressed after an oxaliplatin-containing regimen

After chemotherapy US FDA

Compare all 11 colorectal cancer medicines

Medicine	Generic name	Colorectal cancer type	Form	Approved by
Braftovi	encorafenib	BRAF V600E	Capsule	US FDA
Lumakras	sotorasib	KRAS G12C	Tablet	US FDA
Opdivo	nivolumab	MSI-H/dMMR	IV infusion	US FDA
Jemperli	dostarlimab	MSI-H/dMMR	IV infusion	US FDA
Trastuzumab Rezetecan	trastuzumab rezetecan	HER2-positive	IV infusion	China NMPA
Vitrakvi	larotrectinib	NTRK fusion	Capsule	US FDA
Rozlytrek	entrectinib	NTRK fusion	Capsule	US FDA
Augtyro	repotrectinib	NTRK fusion	Capsule	US FDA
Fruzaqla	fruquintinib	After chemotherapy	Capsule	US FDA
Elunate	fruquintinib	After chemotherapy	Capsule	China NMPA
Zaltrap	ziv-aflibercept	After chemotherapy	IV infusion	US FDA

Papers that usually come before the prescription

Because each approval is tied to a test result or to earlier treatment, your oncologist will normally want these on file:

Paper	What it shows	Medicines that depend on it
Biopsy or surgery histopathology report	Confirms adenocarcinoma of the colon or rectum and its stage	All
RAS and BRAF test	KRAS G12C points to Lumakras with panitumumab; BRAF V600E points to Braftovi with cetuximab	Lumakras, Braftovi
MSI test or MMR immunohistochemistry	MSI-high or dMMR tumours can be treated with immunotherapy; Jemperli's rectal approval covers stage II/III disease	Opdivo, Jemperli
HER2 test	Needed before a HER2-targeted antibody-drug conjugate	Trastuzumab Rezetecan
NTRK fusion result (from a sequencing panel)	Required before any of the NTRK medicines	Vitrakvi, Rozlytrek, Augtyro
List of chemotherapy already given	Fruzaqla, Lumakras and the single-agent Opdivo use require earlier fluoropyrimidine, oxaliplatin and irinotecan; Zaltrap follows an oxaliplatin regimen	Fruzaqla, Elunate, Lumakras, Opdivo, Zaltrap

Import permit, hospital delivery and help with cost

Every medicine here is imported in the name of one patient. Our pharmacist fills in Form 12A in the patient's name, the patient files it with CDSCO, and CDSCO then grants the import permit on Form 12B. For the full checklist of documents, see how the Form 12A and 12B permit works. Opdivo, Jemperli, Zaltrap and Trastuzumab Rezetecan are given as a drip in hospital, so they can be sent directly to the hospital pharmacy by cold-chain hospital delivery.

Some combinations on this page need a second medicine, such as cetuximab with Braftovi or panitumumab with Lumakras, and treatment often continues for months. Our patient support and access programs page lists manufacturer programs, government schemes and charities that may reduce the cost.

How to get these colorectal cancer medicines in India

Prescription
Your oncologist prescribes the medicine.

Share documents
Send the prescription and latest reports through Online Order.

Import paperwork
Our team checks the source and the import permissions.

Delivery
Delivered with the right storage, including cold chain.

Read How to Order and Indian import regulations. We also serve patients in Delhi NCR, Bangalore, Chennai, Mumbai, Kolkata and Hyderabad.

Has your oncologist prescribed one of these medicines?

Share the prescription and we will guide you on availability and next steps.

Online Order

References

IARC Global Cancer Observatory. GLOBOCAN 2024 – India fact sheet (September 2026). https://gco.iarc.who.int/media/globocan/factsheets/populations/356-india-fact-sheet.pdf
IARC Global Cancer Observatory. GLOBOCAN 2024 – Colorectum fact sheet (July 2026). https://gco.iarc.who.int/media/globocan/factsheets/cancers/41-colorectum-fact-sheet.pdf
Deo SVS et al. Colorectal cancers in low- and middle-income countries: demographic pattern and clinical profile of 970 patients treated at a tertiary care cancer center in India. JCO Glob Oncol. 2021;7:1110-1115. https://pubmed.ncbi.nlm.nih.gov/34236917/
Raj S et al. Epidemiological trends of colorectal cancer cases in young population of Eastern India. J Cancer Res Ther. 2024;20(3):817-821. https://pubmed.ncbi.nlm.nih.gov/39023588/
Rao AN et al. Colorectal cancer trends in younger versus older adults: an analysis from a tertiary cancer centre. Indian J Surg Oncol. 2026;17(6):1350-1355. https://pubmed.ncbi.nlm.nih.gov/42381789/
Sharma V et al. Metastatic colo-rectal cancer: real life experience from an Indian tertiary care center. BMC Cancer. 2021;21:630. https://pubmed.ncbi.nlm.nih.gov/34049505/
Shetty O et al. The prevalence of BRAF, PIK3CA, and RAS mutations in Indian patients with colorectal cancer. South Asian J Cancer. 2022;11(3):190-194. https://pubmed.ncbi.nlm.nih.gov/36620501/
Jauhri M et al. Prevalence and coexistence of KRAS, BRAF, PIK3CA, NRAS, TP53, and APC mutations in Indian colorectal cancer patients. Tumour Biol. 2017;39(2). https://pubmed.ncbi.nlm.nih.gov/28222664/
Sheth H et al. Pan-cancer prevalence of microsatellite instability and Lynch syndrome in India. Fam Cancer. 2026;25(4):93. https://pubmed.ncbi.nlm.nih.gov/42842020/
US FDA prescribing information for each US-approved medicine (DailyMed). https://dailymed.nlm.nih.gov/dailymed/

This page gives general information only and does not replace medical advice. All medicines listed are prescription-only and must be used under a qualified oncologist.

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