[New therapy options in colorectal carcinoma].
The introduction of new agents improved chemotherapeutic options in colorectal cancer. Combination therapy with irinotecan or oxaliplatin, both with infusional 5-FU and folinic acid increased response rates to ca. 50% and prolongs--with effective second line therapy--median overall survival to 20 months in patients with metastatic colorectal cancer. Furthermore, the increased response rates allow neoadjuvant treatment of liver metastasis with the aim of a secondary' resection of liver metastasis. Oral 5-FU prodrugs (i.e. capecitabine) are a convenient alternative but have to prove a comparable efficacy to infusional 5-FU. The most recent studies investigated monoclonal antibodies in the treatment of metastatic colorectal cancer. The additional therapy with the VEGF-antibody bevacizumab prolongs survival by more than 4 months compared to chemotherapy alone. The EGF-receptor antibody cetuximab is an effective therapy after progression with irinotecan.
Folprecht
G
G
Medizinische Klinik I, Universitätsklinikum Carl Gustav Carus, Dresden. Gunnar.Folprecht@uniklinikum-dresden.de
Köhne
C H
CH
D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000069287:Capecitabine; D000068818:Cetuximab; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000556:secondary; D003131:Combined Modality Therapy / Q000379:methods / Q000639:trends; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018572:Disease-Free Survival; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D000077146:Irinotecan; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D011355:Prodrugs / Q000008:administration & dosage; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D011355:Prodrugs; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000069287:Capecitabine; D000077146:Irinotecan; D000068818:Cetuximab; D005472:Fluorouracil; D002166:Camptothecin