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Current controversies in the management of metastatic colorectal cancer

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Abstract

The factors affecting the decisions for the treatment for patients with metastatic colorectal cancer (mCRC) are related to the patient, the tumor, and the treatment itself. Both cetuximab and panitumumab are anti-EGFR monoclonal antibody options for patients with RAS wild-type tumors. Several trials comparing these agents with bevacizumab are analyzed in this paper. The liver is the most common site of metastases in patients with CRC, and perioperative chemotherapy has been shown to yield benefits in this setting. In the second-line treatment for mCRC, maintenance with bevacizumab after progression following first-line treatment is convenient in some groups of patients with mCRC. Also, aflibercept has demonstrated benefits in response rate, progression-free survival, and overall survival in second-line treatment, whereas regorafenib provides benefits to patients progressing on all standard therapies. Several novel therapeutic options for patients with mCRC are under development, and these are discussed.

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Acknowledgments

The authors wish to thank Ana Martín from HealthCo S.L. (Madrid, Spain) for her help in preparing the first draft of this manuscript. The necessary scientific meetings along with medical writing services were supported financially by Sanofi Spain. Sanofi Spain was given the opportunity to comment on the first draft of the manuscript, but all the decisions about its content were taken by the authors. All authors have approved the final version of the submitted manuscript.

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Authors and Affiliations

  1. Medical Oncology Department, Navarra Hospital Complex, Calle Irunlarrea, 3, 31008, Pamplona, Navarra, Spain

    Ruth Vera

  2. Medical Oncology Department, Miguel Servet University Hospital, Saragossa, Spain

    Vicente Alonso

  3. Medical Oncology Department, Elche General University Hospital, Elche, Alicante, Spain

    Javier Gállego

  4. Medical Oncology Department, Virgen de las Nieves University Hospital, Granada, Spain

    Encarnación González

  5. Medical Oncology Department, IRYCIS, Ramón y Cajal University Hospital, Madrid, Spain

    Carmen Guillén-Ponce

  6. Medical Oncology Department, Sabadell University Hospital, Sabadell, Barcelona, Spain

    Carles Pericay

  7. Medical Oncology Department, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain

    Fernando Rivera

  8. Medical Oncology Department, General University Hospital of Valencia, Valencia, Spain

    Mª José Safont

  9. Medical Oncology Department, Biomedical Research Institute INIBIC, A Coruña University Hospital, A Coruña, Spain

    Manuel Valladares-Ayerbes

Authors
  1. Ruth Vera
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  2. Vicente Alonso
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  3. Javier Gállego
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  4. Encarnación González
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  5. Carmen Guillén-Ponce
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  6. Carles Pericay
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  7. Fernando Rivera
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  8. Mª José Safont
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  9. Manuel Valladares-Ayerbes
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Corresponding author

Correspondence to Ruth Vera.

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The authors declare that they do not have any conflict of interest that may inappropriately influence this work.

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Vera, R., Alonso, V., Gállego, J. et al. Current controversies in the management of metastatic colorectal cancer. Cancer Chemother Pharmacol 76, 659–677 (2015). https://doi.org/10.1007/s00280-015-2808-6

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  • DOI: https://doi.org/10.1007/s00280-015-2808-6

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