title: Potentially resectable metastatic colorectal cancer: an individualized approach to conversion therapy.
abstract: Colorectal cancer is one of the most common cancers worldwide. In recent years, the survival of patients with metastatic disease has improved due to the developments in both medical and surgical care. Patients with technically unresectable metastatic disease could benefit from a multidisciplinary approach for their possible shift toward a technically resectable condition; the choice of the most effective systemic treatment is then crucial to allow conversion to resectability. Systemic conversion therapy may include chemotherapy agents' combinations (fluoropyrimidine, irinotecan and oxaliplatin), with or without targeted agents (cetuximab, panitumumab, bevacizumab). The choice of the best treatment option has to be evaluated by taking into account each patient's baseline characteristics, biological and pathological information and surgical strategy. In particular, the role of some biologic characteristics of the disease, namely the mutational status of EGFR-pathway oncogenes, is emerging as an important predictive factor of response to anti-EGFR targeted agents. Patients presenting with colorectal cancer metastases should be evaluated for multimodal management with curative intent as the appropriate chemotherapy regimen may induce tumor shrinkage, conversion to resectability and improved survival.
authors.affiliation: Department of Medical Oncology, University of Turin Medical School, Candiolo Cancer Institute, FPO, IRCCS, Candiolo 10060, Italy. Electronic address: donatella.marino@ircc.it.
authors.forename: Donatella
authors.initials: D
authors.lastname: Marino
authors.affiliation: Department of Medical Oncology, University of Turin Medical School, Candiolo Cancer Institute, FPO, IRCCS, Candiolo 10060, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Leone
authors.affiliation: Department of Medical Oncology, University of Turin Medical School, Candiolo Cancer Institute, FPO, IRCCS, Candiolo 10060, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: D'Avanzo
authors.affiliation: Department of General Surgery and Surgical Oncology, Mauriziano "Umberto I" Hospital, Turin 10128, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Ribero
authors.affiliation: Department of General Surgery and Surgical Oncology, Mauriziano "Umberto I" Hospital, Turin 10128, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Capussotti
authors.affiliation: Department of Medical Oncology, University of Turin Medical School, Candiolo Cancer Institute, FPO, IRCCS, Candiolo 10060, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Aglietta
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D006801:Humans; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis; D057285:Precision Medicine; D016896:Treatment Outcome
keywords: Chemotherapy; Colorectal cancer; Colorectal cancer metastases; Conversion therapy; Metastasectomy; Resection; Targeted therapies