title: Target-based agents in neoadjuvant treatment of liver metastases from colorectal cancer: secret weapons in anti-cancer war?
abstract: The therapeutic options for liver metastases of colorectal cancer mainly include surgical resection and palliative chemotherapy. More recently, the increased availability of new and more active cytotoxic drugs has increased the appeal of a combined treatment strategy, in which chemotherapy is administered before surgery. However, the efficacy of neoadjuvant chemotherapy of CRC liver metastases is limited by: (1) the persistence of micro metastatic foci that cannot be seen by conventional imaging techniques, placed either in other sites throughout the liver and/or in the site of the previous macroscopic metastasis that has undergone to clinical complete response; (2) the occurrence of escape mechanisms. The molecular basis regulating these processes are described and the first clinical attempts to overcome these mechanisms through the use of target-based agents are also reported. Finally, biological rationales to optimize the activity of these agents in neoadjuvant setting are discussed.
authors.affiliation: Department of Biochemistry and Biophysics, Second University of Naples, Naples, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Marra
authors.forename: Aldo
authors.initials: A
authors.lastname: Giudice
authors.forename: Claudio
authors.initials: C
authors.lastname: Arra
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vitale
authors.forename: Sara
authors.initials: S
authors.lastname: Castiglioni
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Nasti
authors.forename: Angela
authors.initials: A
authors.lastname: Lombardi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ottaiano
authors.forename: Gaetano
authors.initials: G
authors.lastname: Facchini
authors.forename: Rosario V
authors.initials: RV
authors.lastname: Iaffaioli
authors.forename: Alberto
authors.initials: A
authors.lastname: Abbruzzese
authors.forename: Michele
authors.initials: M
authors.lastname: Caraglia
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D000068818:Cetuximab; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000378:metabolism; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000556:secondary; D008954:Models, Biological; D020360:Neoadjuvant Therapy; D015398:Signal Transduction / Q000187:drug effects; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000068818:Cetuximab