Cure in metastatic disease: how to manage and who is the right patient in colorectal cancer?
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Metastatic colorectal cancer was long considered for palliative therapy, until significant improvement in surgical techniques and more effective chemotherapeutic regimens changed the way metastatic colon cancer patients are being treated today. Prospective trials were designed to answer the question which patient with metastatic disease could potentially be cured by a multidisciplinary approach with medical oncologists, surgeons and radiation oncology using an induction chemotherapy in combination with a targeted agent and being monitored for resectability in multidisciplinary tumor boards. Patients with oligometastatic disease should be treated with the goal of curative resection. This review will highlight studies conducted over the past 15 years addressing this issue. An algorithm is proposed illustrating how every newly diagnosed mCRC (metastatic colorectal cancer) patient could be discussed in the tumor board to decide the best treatment sequence with the best chance of cure.
KeywordsLiver metastases Colorectal cancer Chemotherapy Liver resection Multidisciplinarity
Conflict of interest
T. Gruenberger, P. Jonas, R. Lutz, and B. Gruenberger declare that they have no competing interests.
- 1.Nordlinger B, Sorbye H, Glimelius B, et al. Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet. 2008;371:1007–16.CrossRefPubMedPubMedCentralGoogle Scholar
- 13.Cremolini C, Antoniotti C, Lonardi S, et al. Activity and safety of cetuximab plus modified folfoxiri followed by maintenance with cetuximab or bevacizumab for ras and braf wild-type metastatic colorectal cancer: A randomized phase 2 clinical trial. JAMA Oncol. 2018;4:529–36.CrossRefPubMedGoogle Scholar
- 14.Fornaro L, Lonardi S, Masi G, et al. FOLFOXIRI in combination with panitumumab as first-line treatment in quadruple wild-type (KRAS, NRAS, HRAS, BRAF) metastatic colorectal cancer patients: a phase II trial by the Gruppo Oncologico Nord Ovest (GONO). Ann Oncol. 2013;24:2062–7.CrossRefPubMedGoogle Scholar