Molecularly targeted therapy: toxicity and quality of life considerations in advanced colorectal cancer

Abstract

Colorectal cancer (CRC) is the third most common malignancy and cause of death from cancer among adults worldwide. In recent years, the use of 5-fluorouracil-based regimens in combination with molecularly targeted agents has greatly expanded treatment options for patients with metastatic disease. With a more capillary use of this new class of agents comes the recognition of diverse adverse events related to disturbance of critical biological pathways involved in physiological functions. Proactive management and prevention of adverse events, with a focus on the necessary compromise between adverse events and tumor control, are often effective and allows for uninterrupted, full-dose therapy with targeted agents. Quality of life does not appear deteriorated, rather improved due to efficacy in prolonging wellness.

Omega-3 PUFA Loaded in Resveratrol-Based Solid Lipid Nanoparticles: Physicochemical Properties and Antineoplastic Activities in Human Colorectal Cancer Cells In Vitro

“…Currently, besides surgical removal, both conventional (chemotherapy, and radiotherapy) and innovative approaches (personalized single-targeted therapies) are used for the cure of this cancer [ 4 , 5 , 6 , 7 ], which, in case of early diagnosis, represents one of the most curable ones. However, these therapies often induce significant side-effects [ 8 , 9 ], and their long-term effectiveness may be challenged by acquired resistance [ 10 ]. Additional problems for single-targeted therapies are the high costs and progressive alterations of additional molecular targets during CRC progression.…”

New Trends in the Therapeutic Approach to Metastatic Colorectal Cancer

“…If the metastatic disease is resectable, the first-line treatment priority is immediate tumour control to ameliorate significant disease-related symptoms, to stabilize quickly progressing disease and to reduce metastases before surgery. The medical treatment of mCRC involves recently chemotherapy in combination with new molecular targeted drugs and these new regimens provide a higher resection rate (RR), longer progression free-survival (PFS) and better overall survival (OS) 8 . There is little difference in efficacy between FOLFOX and FOLFIRI and the main difference between these two combination therapies is the toxicity profile; more gastrointestinal side effects, fatigue and alopecia with FOLFIRI and more thrombocytopenia, neurotoxicity and hypersensitive reactions with FOLFOX 1 , 9 , 10 .…”

A Snapshot of Challenges and Solutions in Cancer Drug Development and Therapy

“…Overall, the therapeutic indexes for many of the targeted agents approved or in development for cancer therapy appear greater relative to their cytotoxic alternatives 3 , 4 . However, this is not true for all targeted agents in all individuals, 3 , 5 , 6 , 7 and it is not at all clear whether the wider therapeutic indexes will translate to easier management of therapy for cancer patients, especially in the context of chronic administration and the potential need for combined or supportive therapies 8 .…”