Panelists discuss how real-world dose adjustment decisions in metastatic colorectal cancer are primarily driven by individual patient factors rather than package insert recommendations, emphasizing the importance of understanding each patient’s goals, values, comorbidities, and tolerance thresholds through collaborative multidisciplinary decision-making, since patients frequently ask “how will this make me feel?” and often prioritize quality of life over strict adherence to standard dosing, with the key insight that dose reductions can maximize efficacy by keeping patients on therapy longer rather than causing treatment discontinuation from intolerable toxicities.