Targeted Therapy in Comprehensive Management of Metastatic Colon Cancer

Abstract

In recent years there has been strong progress in the treatment of metastatic colorectal cancer (mCRC) patients. The gain of the median of the overall survival (mOS) rate was more than doubled due to the introduction in the clinical practice of new compounds, the work of a multidisciplinary team, the timely registration of the disease progress, prescription of combined chemotherapy in the second line. The article presents the immediate and long-term results of a comparative study carried out on the basis of Oncology Centers, 122 mCRC patients were included, most of these patients - 87(71,3%) had surgery firstly, after that all patients were treated with standard chemotherapy FOLFOX-4 in the first-line treatment and FOLFIRI in the second line treatment, two groups of patients in the first and second lines of treatment received a combination of chemotherapy and targeted agents (bevacizumab, cetuximab), depending on the biological properties of the tumor (RAS-gene mutation status). The following results: metastatic progression-free survival (mPFS) for FOLFOX-4 group accounted for 12.0(±1.2) months; FOLFOX-4 + Bevacizumab - 20.3(±1.2) months, FOLFOX-4 + cetuximab - 22.0(± 2.0) months; mPFS for second-line therapy for FOLFIRI + bevacizumab group amounted to 24.0(± 3.1) months, FOLFIRI + cetuximab 22.5(±2.5) months, FOLFIRI-1 8.0(±2.4) months, FOLFIRI-2 6.4(±2.6) months; mOS for FOLFOX-4 group was 49.5(±2.5) months; FOLFOX-4 + Bevacizumab - 45.8(±2.1) months; FOLFOX-4 + cetuximab - 37.4(± 2.0) months; mOS for second-line therapy for FOLFIRI + bevacizumab group was 37.8(± 2.1) months, FOLFIRI + cetuximab - 31.5(± 2.3) months, FOLFIRI-1 - 26.3(± 1.8) months, FOLFIRI-2 - 26.2(± 1.9) months. The adverse events during the treatment of patients are reported.