title: [Systemic treatment of advanced colorectal cancer].
abstract: The introduction of modern chemotherapeutic drugs and targeted therapies has substantially changed the treatment of advanced colorectal cancer (aCRC). Thus, median survival of stage IV patients was increased from 6 months under best supportive care to over 2 years if all drugs are administered. Also, new combination therapies may cause irresectable liver metastases to shrink to such an extent that they may be resected (downsizing). Patients who were formerly treated with palliative intent may now be cured. However, not all patients benefit from the new compounds. Very recently, new genetic characteristics were identified as potential molecular biomarkers that may predict response to anti-EGFR therapy, a specific targeted therapy; the marker detected is the mutational status of the oncogene k-ras. Only patients with wild-type k-ras-expressing tumors respond to anti-EGFR antibodies. The integration of biomarker analysis into the clinical routine represents an important step toward customized treatment of cancer patients.
authors.affiliation: Medizinische Universitätsklinik, Knappschaftskrankenhaus, In der Schornau 23-25, 44892 Bochum. anke.reinacher@rub.de
authors.forename: A
authors.initials: A
authors.lastname: Reinacher-Schick
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000473:pathology; D016503:Drug Delivery Systems; D018773:Genes, erbB-1 / Q000235:genetics / Q000276:immunology; D011905:Genes, ras / Q000187:drug effects / Q000235:genetics; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000556:secondary; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents
references.citation: J Clin Oncol. 2007 Apr 20;25(12):1539-44
references.pmid: 17442997
references.citation: J Clin Oncol. 2008 Apr 20;26(12):2006-12
references.pmid: 18421053
references.citation: Ann Oncol. 2004 Dec;15(12):1766-72
references.pmid: 15550581
references.citation: Z Gastroenterol. 2008 Aug;46(8):799-840
references.pmid: 18759205
references.citation: Z Gastroenterol. 2008 May;46(5):435-40
references.pmid: 18461519
references.citation: J Clin Oncol. 2007 May 1;25(13):1658-64
references.pmid: 17470858
references.citation: J Clin Oncol. 2008 Apr 10;26(11):1783-5
references.pmid: 18398143
references.citation: N Engl J Med. 2000 Sep 28;343(13):905-14
references.pmid: 11006366
references.citation: J Natl Cancer Inst. 2004 Oct 6;96(19):1420-5
references.pmid: 15467030
references.citation: N Engl J Med. 2004 Jul 22;351(4):337-45
references.pmid: 15269313
references.citation: J Clin Oncol. 2008 Apr 20;26(12):2013-9
references.pmid: 18421054
references.citation: J Clin Oncol. 2006 Nov 1;24(31):4983-90
references.pmid: 17075116
references.citation: Internist (Berl). 2007 Jan;48(1):51-8
references.pmid: 17160665
references.citation: J Clin Oncol. 2007 Sep 20;25(27):4217-23
references.pmid: 17548840
references.citation: Lancet. 2000 Mar 25;355(9209):1041-7
references.pmid: 10744089
references.citation: N Engl J Med. 2004 Jun 3;350(23):2335-42
references.pmid: 15175435
references.citation: J Clin Oncol. 2008 Apr 1;26(10):1626-34
references.pmid: 18316791
references.citation: Ann Oncol. 2005 Aug;16(8):1311-9
references.pmid: 15870084