Systemic therapy of metastatic colorectal cancer

作者：Kubicka S^*

来源：Onkologe, 2014, 20(8): 725-+.

DOI：10.1007/s00761-014-2672-8

• Colorectal cancer
• Ras status
• First line therapy
• Second line therapy
• Third line therapy

Systemic chemotherapy of patients with metastatic colorectal cancer should provide a long overall survival time together with a high quality of life. Today, systemic chemotherapy of colorectal cancer in different stringent therapeutic lines is frequently replaced by a more individual strategy including maintenance therapies. <br xmlns:set="http://exslt.org/sets">Research of the literature and analysis of clinical trials.
The individual therapeutic strategy is dependent on the age, performance status and comorbidities of the patient as well as the extent and biology of the tumor, the course of the disease and the side effects of the therapy. In all cases where a first line combination chemotherapy is considered, analysis of the complete Ras-status (K-Ras and N-Ras exons 2, 3 and 4) is recommended before the onset of systemic therapy. There is evidence that first line combination chemotherapy with an anti-epidermal growth factor receptor (EGFR) antibody will improve overall survival of patients with Ras wild type tumors. Limited liver and/or lung metastasis should be considered for R0 resection, even if this only seems possible after tumor shrinkage during the course of an intensive induction therapy. The R0 resection of metastases provides a curative option for these patients or at least a long chemotherapy-free interval. In order to obtain the best outcome for patients with metastatic colorectal cancer, a close cooperation of medical oncologists and surgeons in interdisciplinary tumor conferences at the beginning and during the course of systemic therapy is essential.

• 出版日期2014-8