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New Developments in the Second-Line Treatment of Metastatic Colorectal Cancer: Potential Place in Therapy

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Abstract

In this review article we discuss the evolution of second-line treatment options for patients with metastatic colorectal cancer (mCRC). The benefits of second-line chemotherapy have been established for some time, but in the last decade a number of trials have evaluated combinations of irinotecan- and oxaliplatin-based chemotherapy with molecular-targeted agents; e.g., vascular endothelial growth factor (VEGF)-targeting agents (bevacizumab, aflibercept), epidermal growth factor receptor antibodies (cetuximab, panitumumab), and tyrosine kinase inhibitors (vatalanib). Recent developments include the availability of the new VEGF-targeted agent aflibercept and the new concept of continuing bevacizumab after failure of first-line bevacizumab, which is likely to become a new treatment option in the second-line setting. Choosing the most appropriate second-line treatment regimen for mCRC patients remains a complex issue. All of the currently available molecular-targeted agents seem to be active even after patients have received a bevacizumab-based first-line regimen. Overall, the selection of second-line treatment for mCRC depends on several variables and should be determined taking into account the patient’s performance and disease status.

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Acknowledgments

The manuscript was prepared without any funding or contribution of persons not mentioned in the authors’ section.

Conflict of interest

D.A. has received honoraria from Roche, Sanofi, Merck Serono and Amgen, and research support from Roche and Sanofi.

A.S. has received honoraria and travel support from Roche, Sanofi, Merck Serono and Amgen, and research support from Roche and Sanofi.

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  1. Tumor Biology Center Freiburg, Breisacher Str. 117, 79106, Freiburg, Germany

    Dirk Arnold

  2. Hubertus Wald Tumour Center, University Cancer Center Hamburg, Department of Oncology, Hematology, BMT with Section Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Alexander Stein

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Arnold, D., Stein, A. New Developments in the Second-Line Treatment of Metastatic Colorectal Cancer: Potential Place in Therapy. Drugs 73, 883–891 (2013). https://doi.org/10.1007/s40265-013-0076-5

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