title: Update on optimal treatment for metastatic colorectal cancer from the ACTG/AGITG expert meeting: ECCO 2015.
abstract: The treatment of metastatic CRC (mCRC) has evolved over the last 20 years, from fluoropyrimidines alone to combination chemotherapy and new biologic agents. Median overall survival is now over 24 months for RAS mutated (MT) patients and over 30 months for RAS wild-type (WT) patients. However, there are subgroups of patients with BRAF V600E MT CRC who have a significantly poorer outlook. Newer treatment options are also being explored in select subgroups of patients (anti-HER 2 in HER2 positive mCRC and immunotherapy in patients with defective mismatch repair (dMMR)). The best use of these systemic treatment options, as well as surgery in well-selected patients requires careful consideration of predictive biomarkers and importantly, the optimal sequence in which therapies should be given to derive maximal benefit. A group of colorectal subspecialty medical oncologists from Australia, USA, The Netherlands and Germany met during ECCO 2015 in Vienna to review current practice.
authors.affiliation: a Medical Oncology, The Queen Elizabeth Hospital , Adelaide Colorectal Tumour Group and University of Adelaide , Adelaide , Australia.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Price
authors.affiliation: b Medical Oncology, University of Sydney and CTC , Sydney , Australia.
authors.forename: Subotheni
authors.initials: S
authors.lastname: Thavaneswaran
authors.affiliation: c Medical Oncology, Royal Brisbane Hospital , Brisbane , Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Burge
authors.affiliation: d St Vincent's Clinical School, Faculty of Medicine , University of NSW , Sydney , Australia.
authors.forename: Eva
authors.initials: E
authors.lastname: Segelov
authors.affiliation: e Abramson Cancer Centre , University of Pennsylvania , Philadelphia , USA.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Haller
authors.affiliation: f Academic Medical Center , University of Amsterdam , Amsterdam, The Netherlands.
authors.forename: Cornelis Ja
authors.initials: CJ
authors.lastname: Punt
authors.affiliation: g Medical Oncology, Klinik für Tumorbiologie , Freiburg , Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Arnold
authors.affiliation: h Medical Oncology, Flinders Medical Centre , Flinders University and Adelaide Colorectal Tumour Group , Adelaide , Australia.
authors.forename: Christos S
authors.initials: CS
authors.lastname: Karapetis
authors.affiliation: i Medical Oncology, Austin Health , Melbourne , Australia.
authors.forename: Niall C
authors.initials: NC
authors.lastname: Tebbutt
authors.affiliation: j Medical Oncology, Royal Melbourne and Western Hospitals , Melbourne , Australia.
authors.forename: Nick
authors.initials: N
authors.lastname: Pavlakis
authors.affiliation: k Medical Oncology, Royal North Shore Hospital , Sydney University , Sydney , Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Gibbs
authors.affiliation: l Cabrini Medical Centre , Monash University , Melbourne , Australia.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Shapiro
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D014408:Biomarkers, Tumor; D015179:Colorectal Neoplasms / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D053843:DNA Mismatch Repair / Q000235:genetics; D011905:Genes, ras / Q000235:genetics; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D009154:Mutation; D009362:Neoplasm Metastasis; D018579:Patient Selection; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf
keywords: Colorectal cancer; Consensus; RAS; VEGF; biological; chemotherapy