Systemic Treatment of Colorectal Cancer

Abstract

Colorectal cancer is the fourth most common non-cutaneous malignancy in the United States and the second most frequent cause of cancer-related death. Over the past 12 years, significant progress has been made in the systemic treatment of this malignant condition. Six new chemotherapeutic agents have been introduced, increasing median overall survival for patients with metastatic colorectal cancer from less than 9 months with no treatment to approximately 24 months. For patients with stage III (lymph node positive) colon cancer, an overall survival benefit for fluorouracil-based chemotherapy has been firmly established, and recent data have shown further efficacy for the inclusion of oxaliplatin in such adjuvant treatment programs. For patients with stage II colon cancer, the use of adjuvant chemotherapy remains controversial, but may be appropriate in a subset of individuals at higher risk for disease recurrence. Ongoing randomized clinical trials are evaluating how best to combine currently available therapies, while smaller studies are evaluating new agents, with the goal of continued progress in prolonging life among patients with metastatic colorectal cancer and increasing cure rates among those with resectable disease.

Frequent genomic loss at chr16p13.2 is associated with poor prognosis in colorectal cancer

“…1 Currently, the gold standard for prognostication is clinicopathological staging, based on the Tumor, Node, Metastasis (TNM) classifcation. However.…”

Anticancer Effect of COX-2 Inhibitor DuP-697 Alone and in Combination with Tyrosine Kinase Inhibitor (E7080) on Colon Cancer Cell Lines

“…5-FU is a nucleotide analog which was developed in 1957. İrinotecan is a topoisomerase I inhibitor; and oxaliplatin is a platinum-based compound and bulky DNA adduct (Wolpin and Mater, 2008). Standard treatment has evolved from 5-FU, with a median overall survival of 10-12 months and an overall response rate of 10%, to combinations of oxaliplatin and irinotecan that have dramatically improved survival to 14-16 months (Best et al, 2000;Jiang et al, 2012).…”

Molekulare Targets beim Kolonkarzinom

“…20-30% aller Patienten mit kolorektalem Karzinom auf eine Behandlung mit Cetuximab oder Panitumumab an. Für die übrigen Patienten bleiben in der adjuvanten und palliativen Situation nur die bislang eingesetzten Therapeutika wie 5-FU + Leucovorin, Oxaliplatin, Irinotecan, Capecitabine und Bevacizumab, die teilweise in unterschiedlichen Kombinationen (FOLFOX, FOLFIRI) und in Monotherapien eingesetzt werden [18,19,21]. Obwohl zahlreiche retrospektive Studien gezeigt haben, dass das Ansprechen der Chemotherapie mit einer ganzen Reihe von Biomarkern korreliert, ist die Zahl der prospektiven Studien mit einer klinisch brauchbaren Evidenz nur sehr gering [16].…”

“…Seit Oktober 2002 gehört die Früherkennungskoloskopie zu den Vorsorgemaßnahmen der gesetzlichen Krankenversicherung. Ab dem Alter von 55 Jahren können Versicherte eine [21]. S3-Leitlinien sind veröffentlicht worden [18] …”