Skip to main content

Advertisement

Log in

The Role of Targeted Therapy in the Treatment of Advanced Colorectal Cancer

  • Esophogeal/Gastric Small and Large Bowel/Anal Cancer
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

The introduction of targeted therapies in the treatment of metastatic colorectal cancer (MCRC) has resulted in significant improvements in efficacy outcomes. Both vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) inhibitors have proven to be valid and valuable agents in the management of MCRC. This review will focus on the role of the anti-VEGF monoclonal antibody, bevacizumab, and the anti-EGFR monoclonal antibodies, cetuximab and panitumumab, in MCRC. Special focus will be placed on clinical evidence supporting the use of these agents in various lines of treatment, and on KRAS as a marker of response in relationship to anti-EGFR inhibitors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Saltz LB, Cox JV, Blanke C, et al.: Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med 2000;343(13):905–14. doi:10.1056/NEJM200009283431302.

    Article  PubMed  CAS  Google Scholar 

  2. Douillard JY, Cunningham D, Roth AD, et al.: Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet 2000;355(9209):1041–7. doi:10.1016/S0140-6736(00)02034-1.

    Article  PubMed  CAS  Google Scholar 

  3. Sargent DJ, Niedzwiecki D, O’Connell MJ, Schilsky RL.: Recommendation for caution with irinotecan, fluorouracil, and leucovorin for colorectal cancer. N Engl J Med 2001, 345(2):144–145; author reply 6. doi:10.1056/NEJM200107123450213.

    Article  PubMed  CAS  Google Scholar 

  4. de Gramont A, Figer A, Seymour M, et al.: Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 2000;18(16):2938–47.

    PubMed  Google Scholar 

  5. Goldberg RM, Sargent DJ, Morton RF, et al.: A randomized controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 2004;22(1):23–30. doi:10.1200/JCO.2004.09.046.

    Article  PubMed  CAS  Google Scholar 

  6. Colucci G, Gebbia V, Paoletti G, et al.: Phase III randomized trial of FOLFIRI versus FOLFOX4 in the treatment of advanced colorectal cancer: a multicenter study of the Gruppo Oncologico Dell’Italia Meridionale. J Clin Oncol 2005;23(22):4866–75. doi:10.1200/JCO.2005.07.113.

    Article  PubMed  CAS  Google Scholar 

  7. Tournigand C, Andre T, Achille E, et al. FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol 2004;22(2):229–37. doi:10.1200/JCO.2004.05.113.

    Article  PubMed  CAS  Google Scholar 

  8. Cassidy J, Clarke S, Diaz-Rubio E, et al.: Randomized phase III study of capecitabine plus oxaliplatin compared with fluorouracil/folinic acid plus oxaliplatin as first-line therapy for metastatic colorectal cancer. J Clin Oncol 2008;26(12):2006–12. doi:10.1200/JCO.2007.14.9898.

    Article  PubMed  CAS  Google Scholar 

  9. Diaz-Rubio E, Tabernero J, Gomez-Espana A, et al.: Phase III study of capecitabine plus oxaliplatin compared with continuous-infusion fluorouracil plus oxaliplatin as first-line therapy in metastatic colorectal cancer: final report of the Spanish Cooperative Group for the Treatment of Digestive Tumors Trial. J Clin Oncol 2007;25(27):4224–30. doi:10.1200/JCO.2006.09.8467.

    Article  PubMed  CAS  Google Scholar 

  10. Ducreux M, Bennouna J, Hebbar M, et al.: Efficacy and safety findings from a randomized phase III study of capecitabine (X) + oxaliplatin (O) (XELOX) vs. infusional 5- FU/LV  + O (FOLFOX-6) for metastatic colorectal cancer (MCRC). J Clin Oncol 2007, 25, abstract 4029

    Google Scholar 

  11. Porschen R, Arkenau HT, Kubicka S, et al.: Phase III study of capecitabine plus oxaliplatin compared with fluorouracil and leucovorin plus oxaliplatin in metastatic colorectal cancer: a final report of the AIO Colorectal Study Group. J Clin Oncol 2007;25(27):4217–23. doi:10.1200/JCO.2006.09.2684.

    Article  PubMed  CAS  Google Scholar 

  12. Fuchs CS, Marshall J, Mitchell E, et al.: Randomized, controlled trial of irinotecan plus infusional, bolus, or oral fluoropyrimidines in first-line treatment of metastatic colorectal cancer: results from the BICC-C Study. J Clin Oncol 2007;25(30):4779–86. doi:10.1200/JCO.2007.11.3357.

    Article  PubMed  CAS  Google Scholar 

  13. Koopman M, Antonini NF, Douma J, et al.: Sequential versus combination chemotherapy with capecitabine, irinotecan, and oxaliplatin in advanced colorectal cancer (CAIRO): a phase III randomised controlled trial. Lancet 2007;370(9582):135–42. doi:10.1016/S0140-6736(07)61086-1.

    Article  PubMed  CAS  Google Scholar 

  14. Seymour MT, Maughan TS, Ledermann JA, et al.: Different strategies of sequential and combination chemotherapy for patients with poor prognosis advanced colorectal cancer (MRC FOCUS): a randomised controlled trial. Lancet 2007;370(9582):143–52. doi:10.1016/S0140-6736(07)61087-3.

    Article  PubMed  CAS  Google Scholar 

  15. Seymour MT, Punt CJ: CAIRO and FOCUS. Lancet 2007, 370(9603): 1904–1905; author reply 5. doi:10.1016/S0140-6736(07)61807-8

    Google Scholar 

  16. Tournigand C, Cervantes A, Figer A, et al.: OPTIMOX1: a randomized study of FOLFOX4 or FOLFOX7 with oxaliplatin in a stop-and-Go fashion in advanced colorectal cancer—a GERCOR study. J Clin Oncol 2006;24(3):394–400. doi:10.1200/JCO.2005.03.0106.

    Article  PubMed  CAS  Google Scholar 

  17. Maindrault-Goebel F, Lledo G, Chibaudel B, et al.: Final results of OPTIMOX2, a large randomized phase II study of maintenance therapy or chemotherapy-free intervals (CFI) after FOLFOX in patients with metastatic colorectal cancer (MRC): a GERCOR study. J Clin Oncol 2007, 25, abstract 4013

    Google Scholar 

  18. Grothey A, Sargent D. Overall survival of patients with advanced colorectal cancer correlates with availability of fluorouracil, irinotecan, and oxaliplatin regardless of whether doublet or single-agent therapy is used first line. J Clin Oncol 2005;23(36):9441–2. doi:10.1200/JCO.2005.04.4792.

    Article  PubMed  Google Scholar 

  19. Hicklin DJ, Ellis LM.: Role of the vascular endothelial growth factor pathway in tumor growth and angiogenesis. J Clin Oncol 2005;23(5):1011–27. doi:10.1200/JCO.2005.06.081.

    Article  PubMed  CAS  Google Scholar 

  20. Kabbinavar F, Hurwitz HI, Fehrenbacher L, et al.: Phase II, randomized trial comparing bevacizumab plus fluorouracil (FU)/leucovorin (LV) with FU/LV alone in patients with metastatic colorectal cancer. J Clin Oncol 2003;21(1):60–5. doi:10.1200/JCO.2003.10.066.

    Article  PubMed  CAS  Google Scholar 

  21. Hurwitz H, Fehrenbacher L, Novotny W, et al.: Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 2004;350(23):2335–42. doi:10.1056/NEJMoa032691.

    Article  PubMed  CAS  Google Scholar 

  22. Kabbinavar FF, Hambleton J, Mass RD, Hurwitz HI, Bergsland E, Sarkar S.: Combined analysis of efficacy: the addition of bevacizumab to fluorouracil/leucovorin improves survival for patients with metastatic colorectal cancer. J Clin Oncol 2005;23(16):3706–12. doi:10.1200/JCO.2005.00.232.

    Article  PubMed  CAS  Google Scholar 

  23. Scappaticci FA, Skillings JR, Holden SN, et al.: Arterial thromboembolic events in patients with metastatic carcinoma treated with chemotherapy and bevacizumab. Journal of the National Cancer Institute 2007;99(16):1232–9. doi:10.1093/jnci/djm086.

    Article  PubMed  Google Scholar 

  24. Fuchs CS, Marshall J, Barrueco J.: Randomized, controlled trial of irinotecan plus infusional, bolus, or oral fluoropyrimidines in first-line treatment of metastatic colorectal cancer: updated results from the BICC-C study. J Clin Oncol 2008;26(4):689–90. doi:10.1200/JCO.2007.15.5390.

    Article  PubMed  Google Scholar 

  25. Saltz LB, Clarke S, Diaz-Rubio E, et al.: Bevacizumab in combination with oxaliplatin-based chemotherapy as first-line therapy in metastatic colorectal cancer: a randomized phase III study. J Clin Oncol 2008;26(12):2013–9. doi:10.1200/JCO.2007.14.9930.

    Article  PubMed  CAS  Google Scholar 

  26. Giantonio B, Meropol N, Catalano P, et al.: Magnitude of progression-free survival (PFS) improvement and treatment (Tx) duration in metastatic colorectal cancer (mCRC) for bevacizumab (BV) in combination with oxaliplatin-containing regimens: an analysis of two phase III studies. J Clin Oncol 2007, 25, abstract 4073

    Google Scholar 

  27. Hochster HS, Hart LL, Ramanathan RK, et al.: Safety and Efficacy of Oxaliplatin and Fluoropyrimidine Regimens With or Without Bevacizumab As First-Line Treatment of Metastatic Colorectal Cancer: Results of the TREE Study. J Clin Oncol 2008;26(21):3523–9. doi:10.1200/JCO.2007.15.4138.

    Article  PubMed  CAS  Google Scholar 

  28. Giantonio BJ, Catalano PJ, Meropol NJ, et al.: Bevacizumab in combination with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: results from the Eastern Cooperative Oncology Group Study E3200. J Clin Oncol 2007;25(12):1539–44. doi:10.1200/JCO.2006.09.6305.

    Article  PubMed  CAS  Google Scholar 

  29. Kozloff M, Hainsworth J, Badarinath S, et al.: Efficacy of bevacizumab plus chemotherapy as first-line treatment of patients with metastatic colorectal cancer: Updated results from a large observational registry in the US (BRiTE). J Clin Oncol 2006, 24(18S):3537

    Google Scholar 

  30. Kretzschmar A, Van Cutsem E, Michael M, et al.: Preliminary efficacy of bevacizumab with first-line FOLFOX, XELOX, FOLFIRI and monotherapy for mCRC: first BEATrial. J Clin Oncol 2007, 25, abstract 4072

    Google Scholar 

  31. Van Cutsem E, Peeters M, Siena S, et al.: Open-label phase III trial of panitumumab plus best supportive care compared with best supportive care alone in patients with chemotherapy-refractory metastatic colorectal cancer. J Clin Oncol 2007;25(13):1658–64. doi:10.1200/JCO.2006.08.1620.

    Article  PubMed  CAS  Google Scholar 

  32. Hecht J, Chidiac T, Mitchell E, et al.: An interim analysis of efficacy and safety from a randomized controlled trial of panitumumab with chemotherapy plus bevacizumab (Bev) for metastatic colorectal cancer (mCRC): Proceedings of the 9th World Congress on Gastrointestinal Cancer. Ann Oncol 2007, 18, vii21

  33. Hecht JR, Mitchell E, Chidiac T, et al.: A randomized phase IIIB trial of chemotherapy, bevacizumab, and panitumumab compared with chemotherapy and bevacizumab alone for metastatic colorectal cancer. J Clin Oncol 2009, 27(5):672–680

    Google Scholar 

  34. Siena S, Tabernero J, Burkes R, et al.: Phase III study (PRIME/20050203) of panitumumab (pmab) with FOLFOX compared with FOLFOX alone in patients (pts) with previously untreated metastatic colorectal cancer (mCRC): pooled safety data. J Clin Oncol 2008, 26, abstract 4034

    Google Scholar 

  35. Peeters M, Wilson G, Ducreux M, et al.: Phase III study (20050181) of panitumumab (pmab) with FOLFIRI versus FOLFIRI alone as second-line treatment (tx) in patients (pts) with metastatic colorectal cancer (mCRC): pooled safety results. J Clin Oncol 2008, 26, abstract 4064

    Google Scholar 

  36. Van Cutsem E, Nowacki M, Lang I, et al.: Randomized phase III study of irinotecan and 5-FU/FA with or without cetuximab in the first-line treatment of patients with metastatic colorectal cancer (mCRC): The CRYSTAL trial. J Clin Oncol 2007, 25(18S):4000

    Google Scholar 

  37. Bokemeyer C, Bondarenko I, Makhson A, et al.: Cetuximab plus 5-FU/FA/oxaliplatin (FOLFOX-4) versus FOLFOX-4 in the first-line treatment of metastatic colorectal cancer (mCRC): OPUS, a randomized phase II study. J Clin Oncol 2007, 25, abstract 4035

    Google Scholar 

  38. Bokemeyer C, Bondarenko I, Hartmann J, et al.: KRAS status and efficacy of first-line treatment of patients with metastatic colorectal cancer (mCRC) with FOLFOX with or without cetuximab: the OPUS experience. J Clin Oncol 2008, 26, abstract 4000

    Google Scholar 

  39. Punt C, Tol J, Rodenburg C, et al.: Randomized phase III study of capecitabine, oxaliplatin, and bevacizumab with or without cetuximab in advanced colorectal cancer (ACC), the CAIRO2 study of the Dutch Colorectal Cancer Group (DCCG). J Clin Oncol 2008, 26, abstract LBA4011

  40. Brink M, de Goeij AF, Weijenberg MP, et al.: K-ras oncogene mutations in sporadic colorectal cancer in The Netherlands Cohort Study. Carcinogenesis 2003;24(4):703–10. doi:10.1093/carcin/bgg009.

    Article  PubMed  CAS  Google Scholar 

  41. Bazan V, Migliavacca M, Zanna I, et al.: Specific codon 13 K-ras mutations are predictive of clinical outcome in colorectal cancer patients, whereas codon 12 K-ras mutations are associated with mucinous histotype. Ann Oncol 2002;13(9):1438–46. doi:10.1093/annonc/mdf226.

    Article  PubMed  CAS  Google Scholar 

  42. Andreyev HJ, Norman AR, Cunningham D, et al.: Kirsten ras mutations in patients with colorectal cancer: the ‹RASCAL II’ study. Br J Cancer 2001;85(5):692–6. doi:10.1054/bjoc.2001.1964.

    Article  PubMed  CAS  Google Scholar 

  43. Van Cutsem E, Lang I, D’haens G, et al.: KRAS status and efficacy in the first-line treatment of patients with metastatic colorectal cancer (mCRC) treated with FOLFIRI with or without cetuximab: the CRYSTAL experience. J Clin Oncol 2008, 26, abstract 2

  44. Grothey A, Sugrue M, Hedrick E, et al.: Association between exposure to bevacizumab (BV) beyond first progression (BBP) and overall survival (OS) in patients (pts) with metastatic colorectal cancer (mCRC): results from a large observational study (BRiTE). J Clin Oncol 2007, 25, abstract 4036

    Google Scholar 

  45. Sobrero AF, Maurel J, Fehrenbacher L, et al.: EPIC: phase III trial of cetuximab plus irinotecan after fluoropyrimidine and oxaliplatin failure in patients with metastatic colorectal cancer. J Clin Oncol 2008;26(14):2311–9. doi:10.1200/JCO.2007.13.1193.

    Article  PubMed  CAS  Google Scholar 

  46. Fakih MG, Wilding G, Lombardo J.: Cetuximab-induced hypomagnesemia in patients with colorectal cancer. Clinical colorectal cancer 2006;6(2):152–6. doi:10.3816/CCC.2006.n.033.

    Article  PubMed  CAS  Google Scholar 

  47. Tejpar S, Piessevaux H, Claes K, et al.: Magnesium wasting associated with epidermal-growth-factor receptor-targeting antibodies in colorectal cancer: a prospective study. The lancet oncology 2007;8(5):387–94. doi:10.1016/S1470-2045(07)70108-0.

    Article  PubMed  CAS  Google Scholar 

  48. Fakih M.: Management of anti-EGFR-targeting monoclonal antibody-induced hypomagnesemia. Oncology Williston Park NY 2008;22(1):74–6.

    PubMed  Google Scholar 

  49. Adam R, Aloia T, Levi F, et al.: Hepatic resection after rescue cetuximab treatment for colorectal liver metastases previously refractory to conventional systemic therapy. J Clin Oncol 2007;25(29):4593–602. doi:10.1200/JCO.2007.10.8126.

    Article  PubMed  CAS  Google Scholar 

  50. Di Fiore F, Van Cutsem E, Laurent-Puig P, et al.: Role of KRAS mutation in predicting response, progression-free survival, and overall survival in irinotecan-refractory patients treated with cetuximab plus irinotecan for a metastatic colorectal cancer: analysis of 281 individual data from published series. J Clin Oncol 2008, 26, abstract 4035

  51. Rothenberg M, Oza A, Burger B, et al.: Final results of a phase III trial of 5-FU/leucovorin versus oxaliplatin versus the combination in patients with metastatic colorectal cancer following irinotecan, 5-FU, and leucovorin. J Clin Oncol 2003, 22, abstract 1011

    Google Scholar 

  52. Chen HX, Mooney M, Boron M, et al.: Phase II multicenter trial of bevacizumab plus fluorouracil and leucovorin in patients with advanced refractory colorectal cancer: an NCI Treatment Referral Center Trial TRC-0301. J Clin Oncol 2006;24(21):3354–60. doi:10.1200/JCO.2005.05.1573.

    Article  PubMed  CAS  Google Scholar 

  53. Cunningham D, Humblet Y, Siena S, et al.: Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. N Engl J Med 2004;351(4):337–45. doi:10.1056/NEJMoa033025.

    Article  PubMed  CAS  Google Scholar 

  54. Lievre A, Bachet JB, Le Corre D, et al.: KRAS mutation status is predictive of response to cetuximab therapy in colorectal cancer. Cancer Res 2006;66(8):3992–5. doi:10.1158/0008-5472.CAN-06-0191.

    Article  PubMed  CAS  Google Scholar 

  55. Lievre A, Bachet JB, Boige V, et al.: KRAS mutations as an independent prognostic factor in patients with advanced colorectal cancer treated with cetuximab. J Clin Oncol 2008;26(3):374–9. doi:10.1200/JCO.2007.12.5906.

    Article  PubMed  CAS  Google Scholar 

  56. Di Fiore F, Blanchard F, Charbonnier F, et al.: Clinical relevance of KRAS mutation detection in metastatic colorectal cancer treated by Cetuximab plus chemotherapy. Br J Cancer 2007;96(8):1166–9. doi:10.1038/sj.bjc.6603685.

    Article  PubMed  CAS  Google Scholar 

  57. De Roock W, Piessevaux H, De Schutter J, et al.: KRAS wild-type state predicts survival and is associated to early radiological response in metastatic colorectal cancer treated with cetuximab. Ann Oncol 2008;19(3):508–15. doi:10.1093/annonc/mdm496.

    Article  PubMed  Google Scholar 

  58. Jonker DJ, O’Callaghan CJ, Karapetis CS, et al.: Cetuximab for the treatment of colorectal cancer. N Engl J Med 2007;357(20):2040–8. doi:10.1056/NEJMoa071834.

    Article  PubMed  CAS  Google Scholar 

  59. Khambata-Ford S, Garrett CR, Meropol NJ, et al.: Expression of epiregulin and amphiregulin and K-ras mutation status predict disease control in metastatic colorectal cancer patients treated with cetuximab. J Clin Oncol 2007;25(22):3230–7. doi:10.1200/JCO.2006.10.5437.

    Article  PubMed  CAS  Google Scholar 

  60. Amado RG, Wolf M, Peeters M, et al.: Wild-Type KRAS Is Required for Panitumumab Efficacy in Patients With Metastatic Colorectal Cancer. J Clin Oncol 2008, 26(10):1626–1634

    Google Scholar 

  61. Saltz LB, Lenz HJ, Kindler HL, et al.: Randomized phase II trial of cetuximab, bevacizumab, and irinotecan compared with cetuximab and bevacizumab alone in irinotecan-refractory colorectal cancer: the BOND-2 study. J Clin Oncol 2007;25(29):4557–61. doi:10.1200/JCO.2007.12.0949.

    Article  PubMed  CAS  Google Scholar 

  62. Pawlik TM, Vauthey JN, Abdalla EK, Pollock RE, Ellis LM, Curley SA.: Results of a single-center experience with resection and ablation for sarcoma metastatic to the liver. Arch Surg 2006;141(6):537–43; discussion 43–4. doi:10.1001/archsurg.141.6.537.

    Article  PubMed  Google Scholar 

  63. Abdalla EK, Vauthey JN, Ellis LM, et al.: Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Annals of surgery 2004;239(6):818–25; discussion 25–7. doi:10.1097/01.sla.0000128305.90650.71.

    Article  PubMed  Google Scholar 

  64. Fernandez FG, Drebin JA, Linehan DC, Dehdashti F, Siegel BA, Strasberg SM.: Five-year survival after resection of hepatic metastases from colorectal cancer in patients screened by positron emission tomography with F-18 fluorodeoxyglucose (FDG-PET). Annals of surgery 2004;240(3):438–47; discussion 47–50. doi:10.1097/01.sla.0000138076.72547.b1.

    Article  PubMed  Google Scholar 

  65. Sanoff HK, Sargent DJ, Campbell ME, et al.: Five-year data and prognostic factor analysis of oxaliplatin and irinotecan combinations for advanced colorectal cancer: N9741. J Clin Oncol 2008, 26(35):5721–5727

    Google Scholar 

  66. Adam R, Delvart V, Pascal G, et al.: Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival. Annals of surgery 2004;240(4):644–57; discussion 57–58.

    PubMed  Google Scholar 

  67. Folprecht G, Grothey A, Alberts S, Raab HR, Kohne CH.: Neoadjuvant treatment of unresectable colorectal liver metastases: correlation between tumour response and resection rates. Ann Oncol 2005;16(8):1311–9. doi:10.1093/annonc/mdi246.

    Article  PubMed  CAS  Google Scholar 

  68. Falcone A, Ricci S, Brunetti I, et al.: Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest. J Clin Oncol 2007;25(13):1670–6. doi:10.1200/JCO.2006.09.0928.

    Article  PubMed  CAS  Google Scholar 

  69. Leonard GD, Brenner B, Kemeny NE.: Neoadjuvant chemotherapy before liver resection for patients with unresectable liver metastases from colorectal carcinoma. J Clin Oncol 2005;23(9):2038–48. doi:10.1200/JCO.2005.00.349.

    Article  PubMed  CAS  Google Scholar 

  70. Gruenberger B, Tamandl D, Schueller J, et al.: Bevacizumab, capecitabine, and oxaliplatin as neoadjuvant therapy for patients with potentially curable metastatic colorectal cancer. J Clin Oncol 2008;26(11):1830–5. doi:10.1200/JCO.2007.13.7679.

    Article  PubMed  CAS  Google Scholar 

  71. Zorzi D, Chun YS, Madoff DC, Abdalla EK, Vauthey JN: Chemotherapy with bevacizumab does not affect liver regeneration after portal vein embolization in the treatment of colorectal liver metastases. Ann Surg Oncol 2008, 5(10):2765–2772

    Google Scholar 

  72. Reddy SK, Morse MA, Hurwitz HI, et al.: Addition of bevacizumab to irinotecan- and oxaliplatin-based preoperative chemotherapy regimens does not increase morbidity after resection of colorectal liver metastases. Journal of the American College of Surgeons 2008;206(1):96–106. doi:10.1016/j.jamcollsurg.2007.06.290.

    Article  PubMed  Google Scholar 

  73. Ribero D, Wang H, Donadon M, et al.: Bevacizumab improves pathologic response and protects against hepatic injury in patients treated with oxaliplatin-based chemotherapy for colorectal liver metastases. Cancer 2007;110(12):2761–7. doi:10.1002/cncr.23099.

    Article  PubMed  Google Scholar 

  74. Klinger M, Kandutsch S, Hacker S, Gruenberger B, Gruenberger T: Patterns of hepatotoxicity after chemotherapy for colorectal cancer metastases: effect of bevacizumab. J Clin Oncol 2008, 26, abstract 4082

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Marwan Fakih MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fakih, M. The Role of Targeted Therapy in the Treatment of Advanced Colorectal Cancer. Curr. Treat. Options in Oncol. 9, 357–374 (2008). https://doi.org/10.1007/s11864-009-0089-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11864-009-0089-1

Keywords

Navigation