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Gastrointestinal Cancer

Chemotherapy with Targeted Agents for the Treatment of Metastatic Colorectal Cancer

^aKlinik für Onkologie/Hämatologie, Klinikum Oldenburg, Oldenburg, Germany; ^bKeck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA

Key Words. Bevacizumab • Cetuximab • Colorectal cancer • Irinotecan • Panitumumab

Correspondence: Claus-Henning Köhne, M.D., Klinik für Onkologie/Hämatologie, Klinikum Oldenburg, Dr.-Eden-Str. 10, 26133 Oldenburg, Germany. Telephone: 49-441-403-2611; Fax: 49-441-403-2654; e-mail: onkologie{at}klinikum-oldenburg.de

Received September 9, 2008; accepted for publication March 25, 2009; first published online in THE ONCOLOGIST Express on May 1, 2009.

Disclosures: Claus-Henning Köhne: None; Heinz-Josef Lenz: Consultant/advisory role: Pfizer Inc., Genentech, Sanofi-Aventis Group, ImClone, Bristol-Myers Squibb, Merck KG, ResponseGenetics, Inc., Amgen; Honoraria: Pfizer Inc., Genentech, Sanofi-Aventis, ImClone, Bristol-Myers Squibb, Merck KG, Amgen; Ownership interest: ResponseGenetics.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the independent peer reviewers.

The introduction of novel agents targeted to specific molecular features of cancer cells promises more options and marked improvements in efficacy for treatment of colon cancer. This overview of clinical studies describes the effects of administering the targeted agents bevacizumab, cetuximab, and panitumumab, also known as monoclonal antibodies, to treat metastatic colorectal cancer (mCRC) patients. All three targeted agents have been approved for use by the U.S. Food and Drug Administration and the European Agency for the Evaluation of Medicinal Products. Bevacizumab has been shown to extend survival when used in combination with irinotecan and 5-fluorouracil–based chemotherapy, and the addition of cetuximab to irinotecan and 5-fluorouracil–based chemotherapy overcomes irinotecan resistance. Cetuximab and panitumumab are both efficacious among refractory mCRC patients with wild-type KRAS tumors. Other targeted agents, for example, the tyrosine kinase inhibitors erlotinib, gefitinib, sunitinib, and vatalanib (PTK787/ZK 222584), are currently in various stages of clinical development.