[Current medicinal treatment of metastasized colorectal carcinoma]

Abstract

Medical treatment of metastatic colorectal carcinoma has become more effective in recent years. In addition to an increasing number of cytotoxic drugs (e.g. fluoropyrimidines, irinotecan, oxaliplatin), monoclonal antibodies against VEGF or the EGF receptor have become available. These developments, combined with an increasing number of metastasectomies, have improved the prognosis of patients with metastatic colorectal cancer to a median survival of 24-30 months.Starting with the determination of K-RAS mutations the first molecular markers have found a place in the routine diagnostics i. e. to predict which patients have a higher chance (K-RAS wild type) or very low chance (K-RAS mutation) to respond to EGFR antibody treatment. This information complements important clinical factors for the choice of the therapeutic regimen, such as the treatment target (e.g. neoadjuvant treatment of non-resectable liver metastases), tumor symptoms which urgently require a tumor response and comorbidities.