Anti-angiogenic therapies for metastatic colorectal cancer: current and future perspectives

Abstract

Colorectal cancer (CRC) is the fourth most commonly diagnosed cancer and the second leading cause of cancer death in both men and women in the United States, with about 142820 new cases and 50830 deaths expected in 2013. Metastatic disease (mCRC) remains a challenge for oncologists worldwide due to its potential comorbidities. Recently, chemotherapy regimens containing 5-fluorouracil, leucovorin, oxaliplatin and irinotecan combinations are a standard of care in the metastatic disease. Currently, biological therapies involving vascular endothelial growth factor and epidermal growth factor receptor pathways, such as bevacizumab and cetuximab, have emerged as good option for improving mCRC patient survival. Now, aflibercept plus standard chemotherapy has also been approved in second line regimen for mCRC patients. Our review will discuss novel biological drugs and their indications for mCRC patients and will bring future perspectives in this regard.

Keywords: Aflibercept; Bevacizumab; Cetuximab; Colorectal cancer; FOLFIRI; FOLFOX.

Figure 1

Main angiogenesis pathways involving vascular endothelial growth factor and the interactions with anti-angiogenic target drugs. VEGF: Vascular endothelial growth factor. HIF: Hypoxia-inducible factor; EGF: Epidermal growth factor; EGFR: Epidermal growth factor receptor; VEGFR: Vascular endothelial growth factor receptor; PIGF: Placental growth factor.