Conventıonal and targeted therapy in metastatıc colorectal cancer

Abstract

Colorectal cancer is the second leading cause of death in the United States among all cancers.1 Approximately 20% to 25% of colorectal cancer patients are diagnosed with liver metastasis at the time of initial diagnosis and a further 40% to 50% of patients will develop liver metastasis within 3 years from initial diagnosis.2,3 Metastatic colorectal cancer is generally not curable disease. However, a subset of patients with isolated metastases to liver and/or lung are potentially curable with local therapies such as surgery. Treatment is systemic chemotherapy with purpose palliation and control of symptoms, control of tumor growth for patients with non-curable metastatic colorectal cancer. The median survival is 5 to 6 months for metastatic colorectal cancer patients without specific therapy. After fluorouracil plus leucovorin (LV) therapy median survival is approximately 1 year for these patients. The addition of oxaliplatin and irinotecan to the fluorouracil and LV therapy provided an improvement in median survival to nearly 20 months since the year 2000. Finally new pathways has been defined and new therapies started to use which targeted these new pathways. Overall survival was increased with these novel agents such as bevacisumab, cetuximab, panitumumab, other TKİs and immunotherapies.4