Abstract
At the moment, targeted therapy in metastatic colorectal cancer (mCRC) is a hot topic which is widely discussed in the scientific community. Approximately 25 % of all CRC patients present with metastases at the time of initial diagnosis, and an additional 50 % of them will develop metastases during the subsequent course of their disease, contributing to the high mortality rates reported. Novel targeted agents like monoclonal antibodies directed against vascular endothelial growth factors or against epidermal growth factor receptor combined with chemotherapy as well as multikinase inhibitors (in the salvage setting) have demonstrated to result in improved therapeutic outcome in patients with mCRC. Recent research efforts have focused to define patient subpopulations, who benefit most from the respective treatments. KRAS mutations in codons 12 and 13 are found in approximately 40 % of all patients with mCRC. These clinicopathologic characteristics generate consecutive activation of the mitogen-activated protein kinase pathway. Less frequent activating KRAS mutations occur in codons 61 and 146, and there are the NRAS mutations in codons 12, 13, and 61. The gene expression profiles of the RAS genes help to define those patients who are most likely to benefit from certain biological agents. This review discusses the therapeutic options based on recent publications.
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Acknowledgment
The author thanks WS and Mrs. Director for support.
Take-home message
Until now, the use of all chemotherapy regimens (FOLFOX, FOLFIRI) in combination with an antibody should be considered in patients with metastatic colorectal cancer. The treatment decision is complex and depends on molecular markers, clinical factors, as well as patient preferences.
Conflicts of interest
The author declares that the research was conducted in the absence of any commercial or financial relationships that could be constructed as a potential conflict of interest.
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Ulrich-Pur, H. New targets in metastatic colorectal cancer. memo 8, 101–104 (2015). https://doi.org/10.1007/s12254-014-0191-3
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DOI: https://doi.org/10.1007/s12254-014-0191-3