Colorectal cancer treatment: An introduction
Rad Hrvatske akademije znanosti i umjetnosti Medicinske znanosti
Colorectal cancer (CRC) is one of the most frequent type of cancers, and also one of the most frequent causes of death among cancer patients worldwide. Approximately 25% of newly diagnosed patients with CRC have already developed metastases, and 50% of all CRC patients will develop metastases over time as the disease progresses. Active oncological treatment of patients having metastatic CRC nowadays includes fluoropyrimidines in combination with irinotecan and/or oxaliplatin ± monoclonal
... ± monoclonal antibodies (mAbs). Development and introduction of monoclonal antibodies targeting the vascular endothelial growth factor (VEGF; bevacizumab) and the epidermal growth factor receptor (EGFR; cetuximab, panitumumab) in treatment algorithms for patients with wild-type K/N-RAS have significantly improved median overall survival (OS) of patients with metastatic colorectal cancer. Clinical experience supported by various patohistological and molecular biology data indicates that CRC is a heterogeneous disease. The novel approach to treatment decisions should be patient personalized, i.e. such decisions should be tailored according to patient clinical (age, performance status, comorbidities) and molecular (pharmacogenetic) characteristics, tumor disease stage, tumor location and tumor molecular characteristics and patient preferences. Treatment decision for patients with metastatic CRC must be evidence based. The role of the multidisciplinary team in recommendation preparation is unavoidable.