New approaches in systemic treatment of advanced colorectal cancer: the molecular targets era

Abstract

The prognosis of advanced colorectal cancer remains poor in spite of the advances obtained in recent years with new therapeutic agents, new approaches in surgical procedures and new diagnostic methods. New treatments directed to molecular targets have emerged and are being developed to improve these results, but there is a need to optimize and define the best use of these new approaches. In this review, the authors examine the most important trials with monoclonal antibodies and tyrosine kinase inhibitors in the treatment of advanced colorectal cancer.

Sorafenib in radioactive iodine-refractory well-differentiated metastatic thyroid cancer

“… 5 At that time, the 5-year survival of a patient with iodine-concentrating pulmonary metastasis goes from 60%–80% to roughly 30% for those tumors that do not take up iodine. 6 Prior to November 2013, only one FDA-approved drug, doxorubicin, was being used to treat these patients but with a response rate of about 5% according to a recent analysis of modern radiographic images. 7 Sorafenib was approved for the treatment of well-differentiated thyroid cancer according to several Phase II studies and a Phase III study ( Table 1 ) which have consistently shown the induction of stable disease (SD), and, less frequently, partial response (PR), in the setting of progressive metastatic DTC with predictable side effect profiles that are consistent with sorafenib use in other settings.…”

The Role of Capecitabine in the Management of Tumors of the Digestive System

“…In recent years, new targeted agents have been approved for use in the treatment of metastatic CRC, and many other agents are under clinical investigation [39][40][41]. These agents have multiple potential mechanisms of action, including binding and depleting the ligands activating the receptors, blocking the ligand binding site on the receptors, and inhibiting the receptor-associated tyrosine kinases.…”

A randomized phase II study of raltitrexed and gefitinib versus raltitrexed alone as second line chemotherapy in patients with colorectal cancer. (1839IL/0143)

“…Targeting this receptor with cetuximab or panitumumab has demonstrated antitumor effects in patients with CRC as a single agent as well as in combination with chemotherapy [10][11][12][13][14][15][16]. However, targeting the EGFR with small molecules inhibitors of the tyrosine kinase receptor has resulted in mixed results with limited single agent activity but promising results in combination with 5-FU-based chemotherapy [17][18][19]. The combination of gefitinib (Iressa™, AstraZeneca, Ltd) with FOLFOX (oxaliplatin/leucovorin/5-FU) was well tolerated and resulted in a 33% response rate in patients with 5-FU resistant colorectal cancer.…”