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Gastrointestinal Cancer

Innovations in Chemotherapy for Metastatic Colorectal Cancer: An Update of Recent Clinical Trials

Division of Hematology and Oncology, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA

Key Words. Biologic therapy • Chemotherapy • Colorectal cancer • Metastatic

Correspondence: Bert H. O'Neil, M.D., UNC Lineberger Comprehensive Cancer Center, 101 Manning Drive, 3009 Old Clinic Building, Chapel Hill, North Carolina 27599-7305, USA. Telephone: 919-966-4431; Fax: 919-966-6735; e-mail: Bert_oneil{at}med.unc.edu

Received April 4, 2008; accepted for publication August 20, 2008; first published online in THE ONCOLOGIST Express on October 15, 2008.

Disclosure: Employment/leadership position: None; Intellectual property rights/inventor/patent holder: None; Consultant/advisory role: Richard A. Goldberg, Amgen, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Genentech, GlaxoSmithKline, ImClone, Myriad, Pfizer, Poniard, Sanofi-Aventis; Bert H. O'Neil, Sanofi-Aventis, Pfizer, Amgen, Bristol-Myers Squibb; Honoraria: None; Research funding: Richard A. Goldberg, Pfizer, Abbott; Ownership interest: None; Expert testimony: None; Other: None.

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 articleáhave been disclosed by the authors, planners, independent peer reviewers, or staff managers.

It has been estimated that cancer of the colon and rectum (CRC) would be diagnosed in 153,760 men and women in the U.S. alone in 2007. Approximately one in five patients has metastatic CRC (mCRC) at diagnosis, which, at best, is associated with a 5-year survival rate of just 10.3%. Oxaliplatin- and irinotecan-based combination regimens are standard first-line therapies for mCRC. Recent studies suggest that survival outcomes can possibly be further improved by adding biologic agents to chemotherapy. Novel treatment strategies are being investigated to optimize the opportunity for patients to receive and benefit from the increasing number of available active agents and to further improve the efficacy, safety, and tolerability of multiagent therapy. These include switching therapy before progression, maintenance therapy, and chemotherapy-free intervals. Recent innovations in chemotherapy for mCRC are reviewed, with a focus on emerging data that may significantly improve both survival and quality of life for patients with CRC in the future.

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