Adaptation of International Guidelines for Metastatic Colorectal Cancer: An Asian Consensus

• Published in: Clinical colorectal cancer Vol. 13; no. 3; pp. 145 - 155
• Main Authors: Cheng, Ann-Lii, Li, Jin, Vaid, Ashok K, Ma, Brigette Buig Yue, Teh, Catherine, Ahn, Joong B, Bello, Maximino, Charoentum, Chaiyut, Chen, Li-Tzong, de Lima Lopes, Gilberto, Ho, Gwo F, Kong, Hwai L, Lam, Ka O, Liu, Tian S, Park, Young S, Sriuranpong, Virote, Sudoyo, Aru W, Wang, Jaw-Yuan, Zhang, Jun, Zhang, Su Z, Ciardiello, Fortunato, Köhne, Clause-Henning, Shaw, Michael, Kim, Tae Won
• Format: Journal Article Conference Proceeding
• Language: English
• Published: United States Elsevier Inc 01-09-2014
• Subjects: Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal, Humanized - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Asia; Bevacizumab; Camptothecin - administration & dosage; Camptothecin - analogs & derivatives; Cetuximab; Chemotherapy; Colonic Neoplasms - genetics; Colonic Neoplasms - pathology; Colonic Neoplasms - therapy; Combined Modality Therapy; Deoxycytidine - analogs & derivatives; Deoxycytidine - therapeutic use; Drug Combinations; Epidermal growth factor receptor (EGFR)-specific monoclonal antibody; Fluorouracil - administration & dosage; Fluorouracil - analogs & derivatives; Fluorouracil - therapeutic use; Gastroenterology and Hepatology; Guideline Adherence; Hematology, Oncology and Palliative Medicine; Humans; KRAS; Leucovorin - administration & dosage; Liver Neoplasms - genetics; Liver Neoplasms - secondary; Liver Neoplasms - therapy; Lung Neoplasms - genetics; Lung Neoplasms - secondary; Lung Neoplasms - therapy; Magnetic Resonance Imaging; Metastasectomy; Neoplasm Staging; Organoplatinum Compounds - administration & dosage; Oxonic Acid - administration & dosage; Practice Guidelines as Topic; Proto-Oncogene Proteins - genetics; Proto-Oncogene Proteins p21(ras); ras Proteins - genetics; Receptor, Epidermal Growth Factor - antagonists & inhibitors; Rectal Neoplasms - genetics; Rectal Neoplasms - pathology; Rectal Neoplasms - therapy; Targeted therapy; Tegafur - administration & dosage; Tomography, X-Ray Computed; Chemotherapy; KRAS; Epidermal growth factor receptor (EGFR)-specific monoclonal antibody; Asia; Targeted therapy
• ISSN: 1533-0028; 1938-0674
• DOI: 10.1016/j.clcc.2014.06.004

Abstract Colorectal cancer (CRC) is among the most common cancers worldwide, but marked epidemiological differences exist between Asian and non-Asian populations. Hence, a consensus meeting was held in Hong Kong in December 2012 to develop Asia-specific guidelines for the management of metastatic CRC (mCRC). A multidisciplinary expert panel, consisting of 23 participants from 10 Asian and 2 European countries, discussed current guidelines for colon or rectal cancer and developed recommendations for adapting these guidelines to Asian clinical practice. Participants agreed that mCRC management in Asia largely follows international guidelines, but they proposed a number of recommendations based on regional ‘real-world’ experience. In general, participants agreed that 5-fluorouracil (5-FU) infusion regimens in doublets can be substituted with UFT (capecitabine, tegafur-uracil) and S1 (tegafur, 5-chloro-2,4-dihydroxypyridine and oxonic acid), and that the monoclonal antibodies cetuximab and panitumumab are recommended for K RAS wild type tumors. For KRAS mutant tumors, bevacizumab is the preferred biological therapy. FOLFOX (folinic acid, 5-FU, and oxaliplatin) is preferred for initial therapy in Asian patients. The management of mCRC is evolving, and it must be emphasized that the recommendations presented here reflect current treatment practices and thus might change as more data become available.