Refractory Metastatic Colorectal Cancer: Current Challenges and Future Prospects

Refractory Metastatic Colorectal Cancer: Current Challenges and Future Prospects

Despite advances, patients with metastatic colorectal cancer (mCRC) still have poor long-term survival. Identification of molecular subtypes is important to guide therapy through standard treatment pathways and holds promise for the development of new treatments. Following standard first- and second...

Full description

Saved in:
Bibliographic Details
Published in:Cancer management and research Vol. 12; pp. 5819 - 5830
Main Authors: Lam, Marissa, Lum, Caroline, Latham, Sarah, Smith, Sam Tipping, Prenen, Hans, Segelov, Eva
Format: Journal Article
Language:English
Published: Dove Medical Press Limited 01-01-2020
Dove
Dove Medical Press
Subjects:
Antineoplastic agents
Bevacizumab
Cancer metastasis
Care and treatment
Chemotherapy
Colorectal cancer
Development and progression
Epidermal growth factors
genomic profiling
Immunotherapy
molecular targets
Monoclonal antibodies
Nivolumab
precision medicine
Ramucirumab
Review
Tipiracil
Trifluridine
Australia
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Despite advances, patients with metastatic colorectal cancer (mCRC) still have poor long-term survival. Identification of molecular subtypes is important to guide therapy through standard treatment pathways and holds promise for the development of new treatments. Following standard first- and second-line chemotherapy plus targeted agents, many patients retain a reasonable performance status, and thus are seeking further effective treatment to extend life and maintain symptom control. The challenge lies in selecting the most appropriate therapy in the third- and fourth-line settings, from a range of options including the relatively new oral agents TAS-102 and regorafenib, or rechallenge with previous chemotherapy or anti-epidermal growth factor receptor (anti-EGFR) monoclonal antibodies (mAB). Beyond this, therapy consists of trials involving novel agents and new combinations of treatments with theoretical synergy and/or non-overlapping toxicity. There is a great focus on enhancing immunogenicity in mCRC, to reflect the impressive results of immunotherapy drugs in the small cohort with mismatch repair deficient (dMMR) mCRC. Rare molecular subtypes of mCRC are increasingly being identified, including Her2-positive disease, NTRK fusions and others. Clinical trials exploring the efficacy of immunomodulatory and precision agents are plentiful and will hopefully yield clinically meaningful results that can be rapidly translated into routine care.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
content type line 23
ObjectType-Review-1
ISSN:1179-1322
1179-1322
DOI:10.2147/CMAR.S213236