Targeted therapy in advanced colorectal cancer: more data, more questions

Anti-cancer Drugs
Sebastian L Ochenduszko, Krzysztof Krzemieniecki

Abstract

Colorectal cancer (CRC) remains the third most common malignancy and the third leading cause of cancer death worldwide. The introduction of new chemotherapeutics and monoclonal antibodies into the treatment protocols for advanced CRC has significantly improved the outcomes. Nowadays, oncologists have a wide range of agents to choose for the treatment of advanced CRC; however, their optimal administration remains unclear. This article presents recently published data from the trials evaluating the use of monoclonal antibodies in advanced CRC with a particular emphasis on the predictive and prognostic factors of response to targeted therapy. The results from the CRYSTAL and OPUS studies indicate that the benefit from the addition of cetuximab to first-line chemotherapy is restricted to patients with the wild-type KRAS gene, with the best outcomes observed among those with unmutated forms of both the KRAS and BRAF genes. However, that has not been confirmed in the preliminary data from the COIN trial. Panitumumab has been shown to improve the outcomes when combined with first-line and second-line chemotherapy, but again mostly in patients with wild-type KRAS. The article also describes the detrimental effect of combined anti-vascu...Continue Reading

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