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Cancers colorectaux en 2012: que retenir ?

Colorectal cancers in 2012: Which lessons to keep in mind?

  • Dossier Thématique / Thematic File
  • Published:
Côlon & Rectum

Résumé

Au cours de l’année 2012 plusieurs avancées pouvant aboutir à une modification des pratiques ont été présentées. Plusieurs options concernant le dépistage du cancer du côlon sont possibles. La clé de la réussite reste le taux de participation de la population. Le test fécal semble être le mieux accepté en population européenne. Le traitement par antiangiogénique dans les cancers colorectaux métastatique est efficace en deuxième ligne même après progression sous une première ligne comportant un traitement antiangiogénique. Le traitement par anti-EGFR est inefficace en traitement adjuvant des cancers coliques sauf peut-être pour les formes T4N2. Un inhibiteur de tyrosine kinase orale a pour la première fois démontré son efficacité en cas de cancer colorectal résistant à la chimiothérapie. Le traitement par chimiothérapie des patients âgés doit tenir compte de paramètres gériatriques. La détermination du statut KRAS pourrait être facilitée par un test plasmatique, enfin il a été observé l’apparition de clones mutés pour KRAS en cas de traitement par anti-EGFR.

Abstract

During the year 2012, several progresses that could lead to standard cure modification have been published. Several screening strategy are available, the key for success is the participation of the population. The antiangiogenic treatment for advanced colorectal cancer is effective in second line even after progression under first line treatment with antiangiogenic treatment. Anti-EGFR treatment gives no survival benefit for adjuvant therapy except maybe for the T4N2 tumours. An oral tyrosine kinase inhibitor is for the first time efficient in salvage treatment in chemorefractory advanced colorectal cancer. For elderly patient the treatment with chemotherapy should consider geriatric parameters. KRAS status could be determined by plasmatic investigation in the future. KRAS status could also be modified after a treatment with anti-EGFR.

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Références

  1. Schoen RE, Pinsky PF, Weissfeld JL, et al (2012) PLCO Project Team. Colorectal-cancer incidence and mortality with screening flexible sigmoidoscopy. N Engl J Med 366:2345–2357.

    Article  PubMed  CAS  Google Scholar 

  2. Quintero E, Castells A, Bujanda L, et al (2012) COLONPREV Study Investigators. Colonoscopy versus fecal immunochemical testing in colorectal-cancer screening. N Engl J Med 366:697–706

    Article  PubMed  CAS  Google Scholar 

  3. Stoop EM, de Haan MC, de Wijkerslooth TR, et al (2012) Participation and yield of colonoscopy versus non-cathartic CT colonography in population-based screening for colorectal cancer: a randomised controlled trial. Lancet Oncol 13:55–64

    Article  PubMed  Google Scholar 

  4. Rödel C, Liersch T, Becker H, et al (2012) German Rectal Cancer Study Group Preoperative chemoradiotherapy and postoperative chemotherapy with fluorouracil and oxaliplatin versus fluorouracil alone in locally advanced rectal cancer: initial results of the German CAO/ARO/AIO-04 randomised phase 3 trial. Lancet Oncol 13:679–687

    Article  PubMed  Google Scholar 

  5. Hofheinz RD, Wenz F, Post S, et al (2012) Chemoradiotherapy with capecitabine versus fluorouracil for locally advanced rectal cancer: a randomised, multicentre, non-inferiority, phase 3 trial. Lancet Oncol 13:579–588

    Article  PubMed  CAS  Google Scholar 

  6. Sauer R, Liersch T, Merkel S, et al (2012) Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. J Clin Oncol 30:1926–1933

    Article  PubMed  CAS  Google Scholar 

  7. Alberts SR, Sargent DJ, Nair S, et al (2012) Effect of oxaliplatin, fluorouracil, and leucovorin with or without cetuximab on survival among patients with resected stage III coloncancer: a randomized trial. JAMA 307:1383–1393

    Article  PubMed  CAS  Google Scholar 

  8. Taieb J, Tabernero J, Mini E, et al (2012) Adjuvant FOLFOX4 with or without cetuximab in patients with resected stage III colon cancer: DFS and OS results and subgroup analyses of the PETACC8 Intergroup Phase III Trial. LBA4, 30/09/2012, ESMO

  9. Tveit KM, Guren T, Glimelius B, et al (2012) Phase III trial of cetuximab with continuous or intermittent fluorouracil, leucovorin, and oxaliplatin (Nordic FLOX) versus FLOX alone in firstline treatment of metastatic colorectal cancer: the NORDIC-VII study. J Clin Oncol 30:1755–1762

    Article  PubMed  CAS  Google Scholar 

  10. Arnold D, Andre T, Bennouna J, et al (2012) Bevacizumab (BEV) plus chemotherapy (CT) continued beyond first progression in patients with metastatic colorectal cancer previously treated with BEV plus CT: Results of a randomized phase III intergroup study (TML study). J Clin Oncol 30 (suppl; abstr CRA3503)

  11. Allegra CJ, Lakomy R, Tabernero J, et al (2012) Effects of prior bevacizumab use on outcomes from the VELOUR study: A phase III study of aflibercept and FOLFIRI in patients with metastatic colorectal cancer after failure of an oxaliplatin regimen. J Clin Oncol 30 (suppl; abstr 3505)

  12. Díaz-Rubio E, Gómez-España A, Massutí B, et al (2012) Spanish Cooperative Group for the Treatment of Digestive Tumors. Firstline XELOX plus bevacizumab followed by XELOX plus bevacizumab or single-agent bevacizumab as maintenance therapy in patients with metastatic colorectal cancer: the phase III MACRO TTD study. Oncologist 17:15–25

    Article  PubMed  Google Scholar 

  13. Van Cutsem E, Sobrero AF, Siena S, et al (2012) Phase III CORRECT trial of regorafenib in metastatic colorectal cancer (mCRC). J Clin Oncol 30 (suppl; abstr 3502)

  14. Mitry E, Venat-Bouvet L, Phelip JM, et al (2012) Randomized phase III in elderly patients comparing LV5FU2 with or without irinotecan for 1st-line treatment of metastatic colorectal cancer (FFCD 2001-02).529PD ESMO 29/9

  15. Aparicio T, Jouve JL, Teillet L, et al (2012) Geriatric factors to predict chemotherapy feasibility. Ancillary results of FFCD 2001–02 phase III study in first line chemotherapy for metastatic colorectal cancer in elderly patients. J Clin Oncol (in press)

  16. Di Fiore F, Sesboüé R, Michel P, et al (2010) Molecular determinants of anti-EGFR sensitivity and resistance in metastatic colorectal cancer. Br J Cancer 103:1765–1772

    Article  PubMed  Google Scholar 

  17. Bonnes pratiques pour la recherche à visée théranostique de mutations somatiques dans les tumeurs solides. Institut national du cancer. http://www.e-cancer.fr/soins/plates-formes-hospitalieresde-genetique-moléculaire.

  18. Tougeron D, Lecomte T, Pages JC, et al (2012) The effect of lowfrequency KRAS mutations on the response to anti-EGFR therapy in metastatic colorectal cancer. J Clin Oncol 30, suppl; abstr 3520

    Google Scholar 

  19. Bibeau F, Frugier H, Denouel A, et al (2009) Aspect technique de la détermination du statut KRAS dans le cancer colorectal et mise en place en France. Point de vue de l’anatomopathologiste. Bull Cancer 96:S15–S22

    CAS  Google Scholar 

  20. Boissière-Michot F, Lopez-Crapez E, Frugier H, et al (2012) KRAS genotyping in rectal adenocarcinomas specimens with low tumor cellularity after neoadjuvant treatment. Modern Pathol 25:731–739

    Article  Google Scholar 

  21. Thierry A, Moulière F, El Messaoudi S, et al (2012) Circulating DNA analysis shows high concordance with tumor section analysis in the detection of KRAS and BRAF point mutations from colorectal cancer. J Clin Oncol 30 suppl; abstr 10505

    Google Scholar 

  22. Diaz LA, Williams RT, Wu J, et al (2012) The molecular evolution of acquired resistance to targeted EGFR blockade in colorectal cancers. Nature 28:537–540

    Google Scholar 

  23. Misale S, Yaeger R, Hobor S, et al (2012) Emergence of KRAS mutations and acquired resistance to anti-EGFR therapy in colorectal cancer. Nature 28:532–536

    Google Scholar 

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Authors and Affiliations

  1. Service de gastroentérologie, hôpital Avicenne, 125, rue de Stalingrad, 93009, Bobigny cedex, France

    T. Aparicio

  2. Service de pathologie, CRLCC Val d’Aurelle, 34298, Montpellier cedex, France

    F. Bibeau

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  1. T. Aparicio
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  2. F. Bibeau
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Correspondence to T. Aparicio.

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Aparicio, T., Bibeau, F. Cancers colorectaux en 2012: que retenir ?. Colon Rectum 6, 235–240 (2012). https://doi.org/10.1007/s11725-012-0418-6

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  • DOI: https://doi.org/10.1007/s11725-012-0418-6

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