Innovations in Chemotherapy for Metastatic Colorectal Cancer: An Update of Recent Clinical Trials

Abstract

Abstract Learning Objectives After completing this course, the reader should be able to: Use the evolving treatment strategies in metastatic colorectal cancer, including key data from recent clinical trials.Prescribe biologic agents in combination with chemotherapy.Exploit strategies, such as “stop and go” dosing, that may help patients with metastatic colorectal cancer receive optimal therapy in terms of efficacy, with minimal toxicity. CME This article is available for continuing medical education credit at CME.TheOncologist.com It has been estimated that cancer of the colon and rectum (CRC) would be diagnosed in 153,760 men and women in the U.S. alone in 2007. Approximately one in five patients has metastatic CRC (mCRC) at diagnosis, which, at best, is associated with a 5-year survival rate of just 10.3%. Oxaliplatin- and irinotecan-based combination regimens are standard first-line therapies for mCRC. Recent studies suggest that survival outcomes can possibly be further improved by adding biologic agents to chemotherapy. Novel treatment strategies are being investigated to optimize the opportunity for patients to receive and benefit from the increasing number of available active agents and to further improve the efficacy, safety, and tolerability of multiagent therapy. These include switching therapy before progression, maintenance therapy, and chemotherapy-free intervals. Recent innovations in chemotherapy for mCRC are reviewed, with a focus on emerging data that may significantly improve both survival and quality of life for patients with CRC in the future.