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Review
. 2019 Mar 27:12:2271-2278.
doi: 10.2147/OTT.S194605. eCollection 2019.

Selecting treatment options in refractory metastatic colorectal cancer

Margaret Byrne  1 , Muhammad Wasif Saif  1
Affiliations
Review

Selecting treatment options in refractory metastatic colorectal cancer

Margaret Byrne et al. Onco Targets Ther. .

Abstract

Survival of patients with metastatic colorectal cancer (mCRC) has significantly improved in the last decade. Survival gains are not driven by advances in first-line therapy but by incremental additional effects of subsequent treatment lines. To maximize outcomes, patients should receive all active agents. Identification of patient subgroups is increasing individualization of treatment. Novel oral agents, such as regorafenib and TAS-102, as well as promising immunotherapeutic agents have offered salvage treatment options for refractory mCRC. Although most therapeutic developments for mCRC in the chemorefractory setting focuses on new targets and/or more potent agents, reconsideration of established targets has gained importance with the growth of a rational pharmacogenomic approach to drug development, such as HER2. The authors describe treatment options for patients with refractory colon cancer following first- and second-line therapy.

Keywords: FOLFIRI; HER2; KRAS; Lonsurf; NRAS; PD-1 inhibitor; TKI; advanced; bevacizumab; cetuximab; colon cancer; epidermal growth factor receptor; fluoropyrimidine; panitumumab; platelet-derived growth factor receptors; refractory; regorafenib; vascular endothelial growth factor receptor.

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Conflict of interest statement

Disclosure Dr Saif has received research funding from Taiho and has also received honorarium for speaking for Lonsurf. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Schema of the ReDOS for patients with refractory mCRC. Note: *Patients also randomized within each treatment arm to receive preemptive or reactive clobetasol for HFSR. Abbreviations: mCRC, metastatic colorectal cancer; ReDOS, Regorafenib Dose Optimization Study; WT, wild-type.
See this image and copyright information in PMC

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